Effect of transjugular intrahepatic portosystemic shunt formation on portal hypertensive gastropathy and gastric circulation

The American Journal of Gastroenterology
S MezawaY Niitsu

Abstract

The aim of this study was to investigate the effect of a transjugular intrahepatic portosystemic shunt (TIPS) on portal hypertensive gastropathy (PHG) and gastric hemodynamics. A total of 16 patients with cirrhosis and portal hypertensive gastropathy were prospectively studied. Of these, 12 patients underwent TIPS for esophageal varices and four for refractory ascites. Gastric mucosal blood flow (GMBF) was assessed by laser Doppler flowmeter, and total blood flow (TBF) in submucosa and mucosa by near-infrared endoscopy. Portal venous pressure was obtained by a transducer during the TIPS procedure. The severity of portal hypertensive gastropathy was classified as none, mild, or severe. The examinations were performed before and 2 wk after the procedure. TIPS significantly reduced portal venous pressure. PHG improved in all four patients with severe PHG and in five of 12 patients with mild PHG after treatment. Gastric mucosal blood flow increased from 49.0 to 55.6 ml/min/100 g after TIPS. In contrast, TBF decreased from 0.35/s to 0.27/s after treatment. Liver function tests showed no significant changes before and after the procedure. It is considered that TIPS may have a beneficial effect on PHG at least for a short time. The me...Continue Reading

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Citations

Jan 10, 2009·World Journal of Gastroenterology : WJG·Dag Arne Lihaug HoffJan Gunnar Hatlebakk
Aug 22, 2015·Expert Review of Gastroenterology & Hepatology·Patrick SnyderSeth A Gross
Sep 22, 2012·AJR. American Journal of Roentgenology·Nicholas FidelmanRobert K Kerlan
Apr 1, 2014·Clinics in Liver Disease·Nathalie H Urrunaga, Don C Rockey
Jun 11, 2014·Liver International : Official Journal of the International Association for the Study of the Liver·Jonel TrebickaTilman Sauerbruch
Jul 17, 2013·World Journal of Gastrointestinal Endoscopy·George Fred Soares de MacedoLucio Giovanni Battista Rossini
Sep 28, 2004·The American Journal of Gastroenterology·Manuela MerliOliviero Riggio
Oct 13, 2006·European Journal of Gastroenterology & Hepatology·George Therapondos, Florence Wong
Jan 18, 2003·Current Gastroenterology Reports·Timothy M McCashland
Jan 29, 2008·Current Treatment Options in Gastroenterology·Cristina Ripoll, Guadalupe Garcia-Tsao
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Jun 12, 2010·Liver International : Official Journal of the International Association for the Study of the Liver·Raul Cubillas, Don C Rockey
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Apr 12, 2021·Clinics in Liver Disease·Anna BaigesJuan Carlos García-Pagán
Jul 19, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Justin R BoikeUNKNOWN Advancing Liver Therapeutic Approaches (ALTA) Consortium

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