The management of portal hypertension complicated by iterative gastro-intestinal bleeding remains challenging, especially in a low-income environment. Interventional radiology and endoscopic treatments are not always accessible, and a definitive surgical option may prove to be lifesaving. We report a new technique of surgical portosystemic shunt that can be performed in all contexts. We describe the surgical technique of a H-shaped splenorenal shunt using autologous rolled up peritoneum as a vascular graft.
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Background And Aim: There is paucity of data about the prevalence of cirrhosis and portal hypertension in the US general population.
Methods: We used National Health and Nutrition Examination Surveys (NHANES 2017-2020) to estimate the prevalence of cirrhosis and clinically significant (CS)-portal hypertension in alcoholic liver disease (ALD), MetALD, viral hepatitis (VH) to include chronic hepatitis B (CHB) and chronic hepatitis C (CHC), and metabolic dysfunction-associated steatotic liver disease (MASLD). Cirrhosis was evaluated using liver stiffness measurement (LSM) by transient elastography or FIB-4 score; CS-portal hypertension was defined via LSM and platelet count or the use of non-selective beta-blockers in the presence of cirrhosis.
Value of Spleen Dynamic Contrast-enhanced Ultrasound Parameters in Predicting Hepatic Vein Pressure Gradient for Patients With Liver Cirrhosis.
J Clin Gastroenterol
January 2025
The Third Central Hospital of Tianjin, Hedong District.
Goals: To explore dynamic contrast-enhanced ultrasound (CEUS) parameters in predicting hepatic vein pressure gradient (HVPG) for patients with liver cirrhosis (LC).
Background: Noninvasive diagnosis of HVPG remains a challenge.
Study: This prospective study included patients with LC undergoing hepatic vein catheterization and pressure measurement at the hospital from May 2021 to January 2023.
Machine learning prediction of hepatic encephalopathy for long-term survival after transjugular intrahepatic portosystemic shunt in acute variceal bleeding.
World J Gastroenterol
January 2025
Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510151, Guangdong Province, China.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for managing complications of portal hypertension, particularly acute variceal bleeding (AVB). While effective in reducing portal pressure and preventing rebleeding, TIPS is associated with a considerable risk of overt hepatic encephalopathy (OHE), a complication that significantly elevates mortality rates.
Aim: To develop a machine learning (ML) model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.
Hemodynamic investigations on the portal hypertension and treatment of transjugular intrahepatic portosystemic shunt (TIPS) based on CFD simulation.
J Biomech
January 2025
School of Mechanical Engineering, Hefei University of Technology, Hefei, Anhui 230009, PR China. Electronic address:
Hemodynamic processes from the portal vein(PV) to the inferior vena cava(IVC) were mimicked for three patients with portal hypertension(PH) and the effects of stent parameters on the outcomes of transjugular intrahepatic portosystemic shunt(TIPS) were investigated through computational fluid dynamics(CFD). The liver region was simulated with porous media model and the spatial distributions of superior mesenteric vein(SMV) and splenic vein(SV) blood were solved through the Eulerian multiphase model. The present method is able to simulate the PH flow and predict the PV pressure, the stent shunt rate and the SMV blood proportion after TIPS treatment.
View Article and Find Full Text PDFPulmonary vascular complications of cirrhosis: hepatopulmonary syndrome and portopulmonary hypertension.
Acta Clin Belg
January 2025
Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are two distinct pulmonary vascular complications seen in patients with liver disease and/or portal hypertension. HPS is characterized by disturbed gas exchange and hypoxemia because of intrapulmonary vascular dilatations. POPH is defined by pulmonary arterial hypertension, which might lead to right heart failure.
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