采用保留分流的门静脉与体循环离断术成功治疗伴有大型门体分流的顽固性肝性脑病

Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation.

作者信息

Haraguchi Masafumi, Hirai Satoshi, Nakamura Yutaka, Otsuka Tetsuhiro, Ishimaru Hideki, Sasaki Ryu, Fukushima Masanori, Miuma Satoshi, Miyaaki Hisamitsu, Nakao Kazuhiko

机构信息

Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.

Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan.

出版信息

Intern Med. 2020 Apr 15;59(8):1047-1051. doi: 10.2169/internalmedicine.3955-19. Epub 2020 Feb 1.

DOI:10.2169/internalmedicine.3955-19

PMID:32009096

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7205523/

Abstract

Hepatic encephalopathy (HE) is a significant symptom of decompensated liver cirrhosis. Occlusion of portosystemic shunts is used to treat refractory HE. Nevertheless, these treatments often cause adverse events, such as ascites and esophageal varices. We treated a 57-year-old man with refractory HE using shunt-preserving disconnection of the portal and systemic circulation (SPDPS). After SPDPS, there were no obvious complications, and the patient's ammonia level significantly decreased. To date, the patient has not experienced recurrent HE. SPDPS appears to be a safe and effective treatment method for portosystemic encephalopathy.

摘要

肝性脑病（HE）是失代偿期肝硬化的一个重要症状。门体分流术的闭塞用于治疗难治性HE。然而，这些治疗方法常常会引发不良事件，如腹水和食管静脉曲张。我们采用保留分流的门静脉与体循环断流术（SPDPS）治疗了一名57岁的难治性HE男性患者。SPDPS术后，未出现明显并发症，患者的氨水平显著下降。迄今为止，该患者未经历肝性脑病复发。SPDPS似乎是一种治疗门体性脑病的安全有效的治疗方法。