Surgical treatment of severe postshunt hepatic encephalopathy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1991-01

AUTHORS

Michel H. Dagenais, Denis Bernard, Denis Marleau, Stephen Morgan, Daniel Tassé, Ramsès Wassef, Jean-Pierre Villeneuve, Gilles Pomier-Layrargues, Bernard Willems, Pierre Lavoie

ABSTRACT

Hepatic encephalopathy is a major complication of portal-systemic shunts with an incidence ranging up to 52%. A small fraction of these patients are refractory to medical therapy. Shunt ligation and colonic procedures are the main surgical approaches. The goal of the latter is to diminish the colonic absorption of nitrogenous substances which are involved in the pathophysiology of hepatic encephalopathy. Six patients, whose average age was 55.7 +/- 2.6 years, were operated for severe postshunt encephalopathy requiring 4.3 +/- 0.9 admissions for a total duration of 76 +/- 26 days over 1-11 years. One patient had undergone a splenoral shunt and 5 had a portacaval shunt. One ligation of the shunt and 5 colon exclusions were performed. The average postoperative hospital stay was 21.5 +/- 3.9 days. The mean follow-up was 47 +/- 20 months. The patient with the shunt ligation remains free of encephalopathy 94 months after the procedure and has not bled from his esophageal varices. Among the 5 colon exclusion patients, there were 1 death and 3 complications. Three patients were completely relieved of their hepatic encephalopathy. One of those 3 died of a subarachnoid hemorrhage 28 months after the surgery. The fourth still needs medication to control a persistent, although improved, encephalopathy that required 2 further hospitalizations. Colon exclusion is a useful intervention in very selected cases. It has a lower operative mortality than total colectomy and the advantage over shunt ligation of not reestablishing hypertension in the portal system. More... »

PAGES

109-113

References to SciGraph publications

  • 1987-07. The surgical risk of colectomy in patients with cirrhosis in DISEASES OF THE COLON & RECTUM
  • 1984-10. Portacaval shunts in WORLD JOURNAL OF SURGERY
  • 1984-10. Surgical treatment of portal hypertension: A historical perspective in WORLD JOURNAL OF SURGERY
  • 1981-09. Chronic refractory encephalopathy in DIGESTIVE DISEASES AND SCIENCES
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/bf01658978

    DOI

    http://dx.doi.org/10.1007/bf01658978

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1001688196

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/1994594


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    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/bf01658978'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/bf01658978'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/bf01658978'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/bf01658978'


     

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