Abstract
Background and aims
Spontaneous portosystemic shunt (SPSS) can cause refractory hepatic encephalopathy
(HE) in cirrhotic patients. The embolization of the shunt (ES) can resolve the HE,
while the selective embolization of the splenic vein (SESV) can treat splenorenal
shunts related HE. The aim of this study was to compare the clinical outcomes of ES
and SESV when applied for the treatment of SPSS-induced refractory HE in cirrhotic
patients.
Methods
Patients with refractory HE who were treated with ES or SESV were retrospectively
identified. The clinical outcomes were compared and analyzed.
Results
The 6-month mortality after the ES procedure was significantly higher than that after
the SESV procedure. During the 6-month follow-up, both the white blood cell and the
platelet counts were significantly lower after the ES procedure than after the SESV
procedure. There was a significant increase in aspartate aminotransferase levels after
ES. However, the albumin levels as well as the Child–Pugh score and grade were found
to be significantly improved at 6 months after the undertaking of an SESV (as compared
with baseline).
Conclusion
The 6-month mortality was improved after SESV (as compared with ES) in the treatment
of SPSS-induced refractory HE. A prospective multicenter study for validation is warranted.
Keywords
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Article info
Publication history
Published online: September 26, 2022
Accepted:
August 30,
2022
Received:
July 2,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
