Spontaneous portosystemic shunts in liver cirrhosis : new approaches to an old problem
Vidal-González, Judit (Vall d'Hebron Institut de Recerca (VHIR))
Quiroga, Sergio (Hospital Universitari Vall d'Hebron)
Simón Talero, Macarena (Vall d'Hebron Institut de Recerca (VHIR))
Genescà Ferrer, Joan (Vall d'Hebron Institut de Recerca (VHIR))
Universitat Autònoma de Barcelona

Data:	2020
Resum:	Portal hypertension is the main consequence of liver cirrhosis, leading to severe complications such as variceal hemorrhage, ascites or hepatic encephalopathy. As an attempt to decompress the portal venous system, portal flow is derived into the systemic venous system through spontaneous portosystemic shunts (SPSSs), bypassing the liver. In this review, we aim to provide an overview of the published reports in relation to the prevalence and physiopathology behind the appearance of SPSS in liver cirrhosis, as well as the complications derived from its formation and its management. The role of SPSS embolization is specifically discussed, as SPSSs have been assessed as a therapeutic target, mainly for patients with recurrent/persistent hepatic encephalopathy and preserved liver function. Furthermore, different aspects of the role of SPSS in liver transplantation, as well as in candidates for transjugular intrahepatic portosystemic shunt are reviewed. In these settings, SPSS occlusion has been proposed to minimize possible deleterious effects, but results are so far inconclusive.
Ajuts:	Instituto de Salud Carlos III PI18/00947 Instituto de Salud Carlos III JR17/00029 Instituto de Salud Carlos III FI19/00330
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Collaterals ; Embolization ; Hepatic encephalopathy ; Liver transplant ; Portal hypertension ; Review ; TIPS
Publicat a:	Therapeutic Advances in Gastroenterology, Vol. 13 (september 2020) , ISSN 1756-2848

DOI: 10.1177/1756284820961287
PMID: 33062057

19 p, 1.2 MB

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