Systemic Hemodynamic Changes in Mansonic Schistosomiasis With Portal Hypertension Treated by Azygoportal Disconnection and Splenectomy

Cleva, Roberto de; Pugliese, Vincenzo; Zilberstein, Bruno; Saad, William Abrão; Pinotti, H W; Laudanna, Antônio Atílio

doi:10.1111/j.1572-0241.1999.01086.x

Cited by 18 publications

(16 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on well-established findings [10,11,28,41,51], increased hepatic arterial flow with reduced portal blood flow cannot be justified, as is well documented in HSS, by portal overflow. It can be suggested that the total hepatic flow in HSS is actually increased by increasing flows in both vascular beds.…”

Section: Discussionmentioning

confidence: 96%

“…Some angiographic studies have reported small participation of the arterial sector in the hemodynamics of HSS, demonstrating reduction in hepatic artery diameter and poor intrahepatic arterial vasculature [9][10][11]43]. Those authors suggested that, as a result of massive splenomegaly, the splenic artery hypertrophy would deviate the hepatic artery flow.…”

Section: Discussionmentioning

confidence: 99%

“…In HSS, despite obliterative changes in the portal venous system, the total hepatic blood flow remains preserved [41,43]. It remains controversial whether its preservation is simply due to portal blood hyperflow secondary to splenomegaly or whether there is a compensatory mechanism increasing arterial flow [5,9,10,26,[44][45][46][47][48].…”

Section: Discussionmentioning

confidence: 99%

“…Changes in the hepatic artery vascular bed can be considered compensatory to the decrease in portal vein flow [7,8]. However, changes in arterial vascularization are still the subject of controversy, with angiographic studies showing reduction in arterial perfusion in HSS [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Increased Hepatic Arterial Blood Flow Measured by Hepatic Perfusion Index in Hepatosplenic Schistosomiasis: New Concepts for an Old Disease

et al. 2016

View full text Add to dashboard Cite

Angioscintigraphy could show that patients with HSS had increased HPI, featuring greater liver "arterialization," as previously described for cirrhotic patients. Correlations were also observed between HPI and longitudinal splenic length, caliber of esophageal varices, caliber of portal vein, and blood platelet count. Angioscintigraphy is a promising technique for evaluation of hepatosplenic schistosomiasis.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Increased Hepatic Arterial Blood Flow Measured by Hepatic Perfusion Index in Hepatosplenic Schistosomiasis: New Concepts for an Old Disease

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The reported incidence of PVT in patients with HSS is 33% [6]. A high incidence ranging from 17-63% is observed in patients undergoing splenectomy [5][6][7][8] with a 6.12-fold higher risk in these patients [6]. PVT can further accentuate portal hypertension with complications, such as GI bleeding due to varices, ascites, portal biliopathy, and portosystemic encephalopathy [9] Moreover, it is associated with a hepatic carcinogenic potential since reduced hepatic blood supply causes parenchymal changes [10].…”

Section: Introductionmentioning

confidence: 99%

Hepatosplenic Schistosomiasis-Associated Chronic Portal Vein Thrombosis: Risk Factor for Hepatocellular Carcinoma

Darce

Makdissi

Ando

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Hepatosplenic schistosomiasis is an endemic disease prevalent in tropical countries and is associated with a high incidence of portal vein thrombosis (PVT). Inflammatory changes caused by both parasitic infection and portal thrombosis can lead to the development of chronic liver disease with potential carcinogenesis. This study aimed to assess the incidence of PVT and hepatocellular carcinoma (HCC) in patients with schistosomiasis during a long-term follow-up. Methods: A retrospective study was conducted involving patients with schistosomiasis followed up at our institution between 1990 and 2021. Results: A total of 126 patients with schistosomiasis were evaluated in the study. The mean follow-up time was 16 years (range 5–31). Of the total, 73 (57.9%) patients presented PVT during the follow-up. Six (8.1%) of them were diagnosed with HCC, all of them with portal vein thrombosis diagnosed more than 10 years before. Conclusion: The incidence of HCC in patients with schistosomiasis and chronic PVT highlights the importance of a systematic long-term follow-up in this group of patients.

show abstract

Comparison of prevention and treatment of portal vein thrombosis between proximal splenic vein ligation followed by postoperative transcatheter anticoagulant therapy and systemic anticoagulant therapy in patients with cirrhotic portal hypertension

Bu,

Liu,

Tian

et al. 2023

Portal Hypertension & Cirrhosis

View full text Add to dashboard Cite

AimsSplenectomy combined with pericardial devascularization is one of the important methods to treat hypersplenism, gastrointestinal bleeding, and other complications caused by liver cirrhosis; however, it is accompanied by a high risk of portal vein thrombosis (PVT). This study aimed to explore the preventive and therapeutic effects of proximal splenic vein ligation (PSVL) with postoperative transcatheter anticoagulant therapy (TCAT) on PVT.MethodsThis study retrospectively selected 143 patients with liver cirrhosis and portal hypertension, who received splenectomy combined with pericardial devascularization from June 30, 2018 to June 30, 2021. According to computed tomography photography, within 1 week before the operation, the patients were divided into a prevention group (without preoperative PVT, n = 112) and a treatment group (preoperative PVT, n = 31). Then, each group was subdivided based on the treatment and prevention measures into PSVL + TCAT (n = 70) and systemic anticoagulant therapy (SAT) subgroups (n = 73). The preventive and therapeutic effects of PSVL followed by TCAT on PVT were analyzed.ResultsThe operation time in the PSVL + TCAT subgroups was longer than that in the SAT subgroups (185 ± 76 min vs. 161 ± 55 min; p < 0.01). There was no difference between the two subgroups in terms of operative bleeding (345 ± 82 mL vs. 336 ± 65 mL; p > 0.50). There was no operative death, and all patients recovered uneventfully. In the prevention group, procedure‐related complications occurred in two patients in the PSVL + TCAT subgroup (3.7% [2/54]), including one patient with slight pancreatitis and one patient with chylous leakage, owing to mobilization of the pancreas. The PVT incidence in the prevention group was significantly different between the two subgroups at postoperative 7th day, 3rd month, and 6th month (PSVL + TCAT: 0%, 11.1%, and 5.6% vs. SAT: 39.7%, 31.0%, and 20.7%, respectively; all p < 0.05). In the treatment group, the thrombus regression rate at postoperative 7th day and disappearance rates at the 3rd month and the 6th month of the PSVL + TCAT subgroup were significantly higher than those in the SAT subgroup after anticoagulant and thrombolysis therapy (PSVL + TCAT: 75.0%, 68.8%, and 87.5% vs. SAT: 20.0%, 26.7%, and 40.0%; all p < 0.05).ConclusionsPSVL + TCAT reduces the risk of PVT after splenectomy and is safe and effective in treating PVT during surgery for portal hypertension.

show abstract

Systemic Hemodynamic Changes in Mansonic Schistosomiasis With Portal Hypertension Treated by Azygoportal Disconnection and Splenectomy

Cited by 18 publications

References 38 publications

Increased Hepatic Arterial Blood Flow Measured by Hepatic Perfusion Index in Hepatosplenic Schistosomiasis: New Concepts for an Old Disease

Increased Hepatic Arterial Blood Flow Measured by Hepatic Perfusion Index in Hepatosplenic Schistosomiasis: New Concepts for an Old Disease

Hepatosplenic Schistosomiasis-Associated Chronic Portal Vein Thrombosis: Risk Factor for Hepatocellular Carcinoma

Comparison of prevention and treatment of portal vein thrombosis between proximal splenic vein ligation followed by postoperative transcatheter anticoagulant therapy and systemic anticoagulant therapy in patients with cirrhotic portal hypertension

Contact Info

Product

Resources

About