Embolización de colaterales portosistémicas espontáneas como tratamiento de la encefalopatía hepática refractaria / Embolization of spontaneous portosystemic shunts as treatment for refractory hepatic encephalopathy
Rev. med. Chile
;
150(7): 879-888, jul. 2022. tab, ilus
Artículo
en Español
| LILACS
| ID: biblio-1424156
ABSTRACT
BACKGROUND:
Hepatic encephalopathy (HE) is a common complication of cirrhosis associated with a reduced survival. The presence of high-flux spontaneous porto-systemic shunts can induce HE even in patients with preserved liver function.AIM:
To evaluate the effect of spontaneous porto-systemic shunt embolization (SPSE) over HE and its long-term evolution. MATERIAL ANDMETHODS:
Retrospective analysis of 11 patients (91% males) with severe HE non-responsive to medical treatment in whom a SPSE was performed. The grade of HE (employing West Haven score), survival, MELD and Child-Pugh score, ammonia levels, degree of disability (employing the modified Rankin scale (mRs)) were evaluated before and at thirty days after procedure.RESULTS:
The most common etiology found was non-alcoholic steatohepatitis (63.6%). A reduction of at least two score points of HE was observed in all patients after thirty days. There was a significant reduction on median (IQR) West Haven score from 3 (2-3) at baseline to 1 (0-1) after the procedure (p < 0.01). Twelve months survival was 63.6%. There was a decrease in median ammonia level from 106.5 (79-165) (ug/dL) to 56 (43-61) after SPSE (p = 0.006). The median mRS score before and after the procedure was 3 (3-5) and 1 (1-2.5), respectively (p < 0.01).Conclusions:
According to our experience, SPSE is a feasible and effective alternative to improve HE and functionality of patients with refractory EH.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Encefalopatía Hepática
/
Derivación Portosistémica Intrahepática Transyugular
Límite:
Femenino
/
Humanos
/
Masculino
Idioma:
Español
Revista:
Rev. med. Chile
Asunto de la revista:
Medicina
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Hospital Clínico Red de Salud UC CHRISTUS/CL
/
Hospital Clínico de la Universidad de Chile/CL
/
Pontificia Universidad Católica de Chile/CL
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