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  1 / 1349 MEDLINE  
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[PMID]:28457081
[Au] Autor:Ben-Chetrit E; Abu Rmeileh A; Atlan K; Ben-Chetrit E
[Ad] Endereço:Unit of Infectious Diseases, Shaare Zedek Medical Center, Jerusalem, Israel.
[Ti] Título:Willie Sutton Strikes Again.
[So] Source:Isr Med Assoc J;18(12):756-760, 2016 Dec.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Hiperesplenismo/diagnóstico
Pancitopenia/etiologia
Esplenomegalia/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Equimose/etiologia
Feminino
Febre/etiologia
Seres Humanos
Hiperesplenismo/etiologia
Esplenomegalia/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  2 / 1349 MEDLINE  
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[PMID]:28640110
[Au] Autor:Han D; Tang R; Wang L; Li A; Huang X; Shen S; Dong J
[Ad] Endereço:Department of Hepatopancreatobiliary Surgery, Medical Center, Tsinghua University, Beijing Tsinghua Changgung Hospital, Beijing, China.
[Ti] Título:Case report of a modified Meso-Rex bypass as a treatment technique for late-onset portal vein cavernous transformation with portal hypertension after adult deceased-donor liver transplantation.
[So] Source:Medicine (Baltimore);96(25):e7208, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Portal vein thrombosis is a complication after liver transplantation and cavernous transformation of the portal vein (CTPV) is a result of portal vein thrombosis, with symptoms of portal hypertension revealed by an enhanced CT scan. Meso-Rex bypass is an artificial shunt connecting the left portal vein to the superior mesenteric vein and is mainly used for idiopathic cavernomas. This technique is also used for post-transplant portal vein thrombosis in pediatric patients thereby bypassing obstructed sites of the extrahepatic portal vein. Here we report about an adult patient who was treated by connecting the cystic part of the portal vein to the splenic vein instead of the superior mesenteric vein. PATIENTS CONCERN: An adult male patient with post-liver transplantation portal vein cavernous transformation suffered from hypersplenism and elevated hepatic enzymes. DIAGNOSIS: The last follow up revealed irregular and obvious hypersplenism, and splenomegaly had occurred, while an enhanced CT scan revealed serious esophagogastric varices and CTPV in addition to occluded right and common PV trunks. INTERVENTION: The patient was treated by connecting the cystic part of the portal vein to the splenic vein instead of the superior mesenteric vein. OUTCOME: After the operation, a satisfactory velocity was confirmed 1 month postoperatively and the shunt still remained patent at the 6-month postoperation follow-up. LESSONS: A Meso-Rex bypass intervention connecting the left portal vein to the splenic vein instead of the superior mesenteric vein after liver transplantation in an adult patient with right and common portal vein occlusions has been successfully performed as an alternative approach.
[Mh] Termos MeSH primário: Anastomose Cirúrgica
Hemangioma Cavernoso/cirurgia
Hipertensão Portal/cirurgia
Transplante de Fígado/efeitos adversos
Veia Porta/cirurgia
Veia Esplênica/cirurgia
[Mh] Termos MeSH secundário: Hemangioma Cavernoso/diagnóstico por imagem
Hemangioma Cavernoso/enzimologia
Hemangioma Cavernoso/etiologia
Seres Humanos
Hiperesplenismo/diagnóstico por imagem
Hiperesplenismo/enzimologia
Hiperesplenismo/etiologia
Hiperesplenismo/cirurgia
Hipertensão Portal/diagnóstico por imagem
Hipertensão Portal/enzimologia
Hipertensão Portal/etiologia
Masculino
Veias Mesentéricas/cirurgia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007208


  3 / 1349 MEDLINE  
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[PMID]:28352148
[Au] Autor:Li JF; Bai DS; Jiang GQ; Chen P; Jin SJ; Zhu ZX
[Ad] Endereço:Department of Hepatobiliary Surgery, Jingjiang Hospital of Traditional Chinese Medicine, Jingjiang, Jiangsu, China.
[Ti] Título:Laparoscopic and Open Splenectomy and Hepatectomy.
[So] Source:JSLS;21(1), 2017 Jan-Mar.
[Is] ISSN:1938-3797
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Patients undergoing synchronous open splenectomy and hepatectomy (OSH) for concurrent hepatocellular carcinoma (HCC) and hypersplenism usually have major surgical trauma caused by the long abdominal incision. Surgical procedures that contribute to rapid recovery with the least possible impairment are desired by both surgeons and patients. The objective of this study was to explore outcomes in patients treated with simultaneous laparoscopic or open splenectomy and hepatectomy for hepatocellular carcinoma (HCC) with hypersplenism. METHODS: We retrospectively evaluated the treatment outcomes in 23 patients with cirrhosis, HCC, and hypersplenism, who underwent simultaneous laparoscopic splenectomy and hepatectomy (LSH; = 12) or open splenectomy and hepatectomy (OSH; = 11) from January 2012 through December 2015. Their perioperative variables were compared. RESULTS: LSH was successful in all patients. There were nonsignificant similarities between the 2 groups in duration of operation, estimated blood loss, and volume of blood transfused ( > .05 each). Compared with OSH, LSH had a significantly shorter postoperative visual analog scale pain score ( < .001); shorter time to first oral intake ( < .001), passage of flatus ( < .05) and off-bed activity ( < .001); shorter postoperative duration of hospitalization ( < .001); fewer days of postoperative temperature >38.0°C ( < .01); fewer postoperative complications ( < .05); and better liver and renal function on postoperative days 7 ( < .05 each). CONCLUSIONS: Simultaneous LSH is safe for selected patients with HCC and hypersplenism associated with liver cirrhosis.
[Mh] Termos MeSH primário: Carcinoma Hepatocelular/cirurgia
Hepatectomia/métodos
Hiperesplenismo/cirurgia
Laparoscopia
Neoplasias Hepáticas/cirurgia
Esplenectomia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Carcinoma Hepatocelular/complicações
Estudos de Viabilidade
Feminino
Seres Humanos
Hiperesplenismo/complicações
Cirrose Hepática/complicações
Cirrose Hepática/cirurgia
Neoplasias Hepáticas/complicações
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE


  4 / 1349 MEDLINE  
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[PMID]:28316312
[Au] Autor:Wang YB; Zhang JY; Zhang F; Zhao Y; Gong JP
[Ti] Título:Partial Splenic Artery Embolization to Treat Hypersplenism Secondary to Hepatic Cirrhosis: A Meta-Analysis.
[So] Source:Am Surg;83(3):274-283, 2017 Mar 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This meta-analysis aimed to explore the effectiveness of partial spleen arterial embolization (PSAE) in the treatment of hypersplenism secondary to hepatic cirrhosis. PubMed, Embase, Cochrane Library, Wan Fang, CNKI, Vip, and CBM databases were searched for randomized controlled trials, cohort studies, and case-control studies that compared PSAE with splenectomy in the treatment of hypersplenism secondary to hepatic cirrhosis from their inception to July 25, 2015. Statistical analysis was conducted in Cochrane Network RevMan v5.3. Primary outcomes included the pre- and postoperative platelet and leukocyte counts and hemoglobin levels. Secondary outcomes were operative time, intraoperative volume of bleeding, and length of hospital stay. Mean and standard deviation were obtained from each study and then pooled using fixed- or random-effects models to calculate the mean difference. Ten original studies investigating 737 patients were included. Both the PSAE group and the splenectomy group yielded higher postoperative platelet and leukocyte counts and hemoglobin levels than the preoperative. The difference of platelet and leukocyte counts and hemoglobin levels between postoperative and preoperative levels in the PSAE group was smaller than that in the splenectomy group. Besides, compared with the splenectomy group, the PSAE group exhibited shorter operative time, less intraoperative bleeding, and shorter length of stay. PSAE is a mini-invasive therapy, which can be applied to treat hypersplenism secondary to hepatic cirrhosis effectively, particularly for patients with a poor overall condition. However, further high-quality studies should be conducted because this meta-analysis is limited by the quality of studies and the large statistical heterogeneity.
[Mh] Termos MeSH primário: Embolização Terapêutica/métodos
Hiperesplenismo/etiologia
Hiperesplenismo/terapia
Cirrose Hepática/complicações
Artéria Esplênica
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170421
[Lr] Data última revisão:
170421
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE


  5 / 1349 MEDLINE  
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[PMID]:27715476
[Au] Autor:Bai DS; Yang KS; Jiang GQ; Qian JJ; Chen P; Jin SJ
[Ad] Endereço:Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University , Yangzhou, China .
[Ti] Título:Individualized Laparoscopic Therapy for Portal Hypertension: A Preliminary Single Center Experience.
[So] Source:J Laparoendosc Adv Surg Tech A;27(2):121-127, 2017 Feb.
[Is] ISSN:1557-9034
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To investigate the effects and technical points of several individualized laparoscopic therapies for patients suffering from cirrhotic portal hypertension. METHODS: In total, 385 cirrhotic patients who underwent the treatment of individualized laparoscopic therapy from February 2012 to December 2015 at the Clinical Medical College of Yangzhou University were enrolled in this study. We retrospectively analyzed the clinical data and the key technical points. RESULTS: Individualized laparoscopic therapies were successfully performed on 379 of 385 cases. Six cases were converted to a laparotomy (the rate of conversion to laparotomy was 1.6%). Modified laparoscopic splenectomy (MLS) for cirrhotic patients with hypersplenism was successfully performed on 103 of 105 cases. Laparoscopic azygoportal disconnection for cirrhotic patients with esophagogastric variceal bleeding (EGVB) or F3 varices was successfully performed on 61 of 62 cases, and modified laparoscopic splenectomy and azygoportal disconnection (MLSD) for cirrhotic patients with hypersplenism and EGVB or F3 varices was successfully performed on 196 of 201 cases. Synchronous MLS and laparoscopic partial hepatectomy (SLSH) for cirrhotic patients with hypersplenism and hepatocellular carcinoma (HCC) and synchronous MLSD and laparoscopic partial hepatectomy (SLSDH) for cirrhotic patients with hypersplenism, EGVB or F3 varices and HCC were all successfully implemented on 12 and 5 patients, respectively. From May 2013, we used the intraoperative autologous cell salvage during each individualized laparoscopic procedure. CONCLUSIONS: An individualized laparoscopic therapy was beneficial for different state of selected cirrhotic patients with portal hypertension with or without HCC.
[Mh] Termos MeSH primário: Carcinoma Hepatocelular/cirurgia
Varizes Esofágicas e Gástricas/cirurgia
Hemorragia Gastrointestinal/cirurgia
Hipertensão Portal/cirurgia
Laparoscopia/métodos
Neoplasias Hepáticas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Perda Sanguínea Cirúrgica
Carcinoma Hepatocelular/etiologia
Varizes Esofágicas e Gástricas/etiologia
Feminino
Hemorragia Gastrointestinal/etiologia
Hepatectomia/métodos
Seres Humanos
Hiperesplenismo/etiologia
Hiperesplenismo/cirurgia
Hipertensão Portal/etiologia
Tempo de Internação
Cirrose Hepática/complicações
Neoplasias Hepáticas/etiologia
Masculino
Meia-Idade
Estudos Retrospectivos
Esplenectomia/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161008
[St] Status:MEDLINE
[do] DOI:10.1089/lap.2016.0378


  6 / 1349 MEDLINE  
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[PMID]:27577937
[Au] Autor:Ryu T; Takami Y; Tsutsumi N; Tateishi M; Mikagi K; Wada Y; Saitsu H
[Ad] Endereço:Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan. tmk.ryu@kyumed.jp.
[Ti] Título:Simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy for the treatment of hepatocellular carcinoma with cirrhotic hypersplenism.
[So] Source:Surg Today;47(5):548-554, 2017 May.
[Is] ISSN:1436-2813
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To establish the efficacy and safety of simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy (Lap-Sp) for the treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism. METHODS: Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child-Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1-7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1-3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively. RESULTS: The median operating time was 283 min (range 197-418 min) and the median blood loss was 125 mL (range 5-1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3-70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively. CONCLUSIONS: The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.
[Mh] Termos MeSH primário: Técnicas de Ablação/métodos
Carcinoma Hepatocelular/cirurgia
Eletrocoagulação/métodos
Hiperesplenismo/cirurgia
Laparoscopia/métodos
Neoplasias Hepáticas/cirurgia
Esplenectomia/métodos
[Mh] Termos MeSH secundário: Idoso
Carcinoma Hepatocelular/complicações
Feminino
Hepatectomia
Seres Humanos
Hiperesplenismo/complicações
Neoplasias Hepáticas/complicações
Masculino
Micro-Ondas
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160901
[St] Status:MEDLINE
[do] DOI:10.1007/s00595-016-1411-8


  7 / 1349 MEDLINE  
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[PMID]:26989144
[Au] Autor:Mukta V; Panicker LC; Sivamani K; Goel A; Basu D; Dhanapathi H
[Ad] Endereço:Ex-Associate Professor, Associate Professor, Department of Medicine JIPMER, Puducherry, India mukta.wyawahare@gmail.com.
[Ti] Título:Non-cirrhotic portal fibrosis at a tertiary care centre in South India.
[So] Source:Trop Doct;47(1):26-30, 2017 Jan.
[Is] ISSN:1758-1133
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Non-cirrhotic portal fibrosis (NCPF) is one of the important causes of upper gastrointestinal haemorrhage in patients in tropical countries. The aim of this study was to describe the clinical and laboratory profile of 68 patients with NCPF. MATERIAL AND METHODS: NCPF is defined as liver disease with: (1) evidence of portal hypertension; (2) a liver biopsy showing no cirrhosis or a Tc-labelled sulphur colloid scan showing a pattern suggestive of NCPF; and (3) a patent splenoportal axis. The clinical, laboratory and demographic features of 68 patients with such criteria were studied and analysed. RESULTS: NCPF was common in women (73.5%) in the fourth decade of life. The median duration of illness was 24 months (range, 1 month-28 years). Patients presented to hospital with the sensation of a mass in the abdomen (50%) or with haematemesis (26.5%). They had splenomegaly (95.6%) and thrombocytopenia (88.2%). The majority of patients had normal liver function tests. Abdominal ultrasonography showed increased periportal and peri gallbladder echoes (72%), spontaneous collaterals (41.2%) and ascites (19.1%). Liver biopsy revealed portal venous sclerosis (76.3%) and periportal fibrosis (55.3%). Tc-labelled sulphur colloid scan was suggestive of NCPF in the remaining 30 cases. CONCLUSION: NCPF is common in South India. Transient ascites occurs due to decompensation of liver function after variceal bleeding and in long standing cases of NCPF. Our study used Tc-sulphur scan for diagnosing NCPF in patients where liver biopsy was contraindicated in view of severe thrombocytopenia; however, the diagnostic utility of Tc-sulphur nuclear scan to diagnose NCPF in patients with severe hypersplenism needs to be further evaluated in future studies.
[Mh] Termos MeSH primário: Hiperesplenismo/epidemiologia
Hipertensão Portal/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Fibrose/complicações
Fibrose/diagnóstico por imagem
Fibrose/epidemiologia
Fibrose/patologia
Hemorragia Gastrointestinal/etiologia
Seres Humanos
Hiperesplenismo/complicações
Hiperesplenismo/diagnóstico por imagem
Hiperesplenismo/patologia
Hipertensão Portal/complicações
Hipertensão Portal/diagnóstico por imagem
Hipertensão Portal/patologia
Índia/epidemiologia
Masculino
Meia-Idade
Sistema Porta
Fatores de Risco
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160319
[St] Status:MEDLINE


  8 / 1349 MEDLINE  
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[PMID]:27931577
[Au] Autor:Bakula A; Pawlowska J; Niewiadomska O; Jankowska I; Teisseyre M; Kalicinski P; Socha P
[Ad] Endereço:Gastroenterology, Hepatology, Nutrition Disorders and Paediatrics, The Children's Memorial Health Institute, Warsaw, Poland. Electronic address: agnieszkabakula@gmail.com.
[Ti] Título:Liver Transplantation in Polish Children With α -Antitrypsin Deficiency: A Single-Center Experience.
[So] Source:Transplant Proc;48(10):3323-3327, 2016 Dec.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: α -Antitrypsin deficiency (ATD) is the most common genetic cause of liver injury in young children. Asymptomatic hepatitis is observed in most patients. However, the course of liver disease due to ATD is unpredictable, and some children develop liver cirrhosis. Liver transplantation (Ltx) dramatically improves their outcome and in some cases is required in the first years of life. The aim of the study was to evaluate the course of the disease in children with ATD treated with Ltx in a single center. METHODS: We retrospectively reviewed the clinical features (ascites, esophageal varices, esophageal bleeding) and laboratory parameters of liver function in children with ATD who were treated with Ltx. RESULTS: Twenty-two Ltxs were performed in 20 children (13 boys, 7 girls). Median age at transplantation was 12 years (range 0.5 to 17.1). Four children were transplanted in the first 2 years of life and 16 patients were over 7 years old. The indications for Ltx in younger children were progressive cholestasis with coagulopathy and ascites. In older patients, the indications were as follows: liver failure presenting with variceal bleeding in 7 patients, ascites in 5 patients, hypersplenism in all but 1 patient. In the group of children transplanted over 7 years old, the frequency of cholestasis decreased intermittently in the second year of life: 4 patients (25%) compared to 15 patients (94%) and 10 patients (63%) in the neonatal and pretransplant period, respectively. In the group of children transplanted earlier, cholestasis and hepatitis were maintained until Ltx. Of transplanted patients, 50% were malnourished at the transplantation, and 50% were followed for more than 10 years. Five-year post-transplant survival was 100% (n = 14), and 10-year survival was 90%. Two patients died as adults with biliary post-transplant complications and problems with compliance. CONCLUSIONS: Our experience suggests that transient normalization of liver parameters in some patients with ATD do not exclude the liver disease progression to cirrhosis and unfavorable outcome of liver disease in childhood. In our group of patients, median age at transplantation was high compared to other centers. The long-term prognosis in children after transplantation is very good, but early post-transplant complications and probable problems with compliance in young adults may lead to graft failure.
[Mh] Termos MeSH primário: Falência Hepática/cirurgia
Transplante de Fígado/métodos
Deficiência de alfa 1-Antitripsina/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Colestase/etiologia
Colestase/cirurgia
Varizes Esofágicas e Gástricas/etiologia
Feminino
Hemorragia Gastrointestinal/etiologia
Sobrevivência de Enxerto
Seres Humanos
Hiperesplenismo/etiologia
Lactente
Falência Hepática/etiologia
Masculino
Polônia
Prognóstico
Estudos Retrospectivos
Deficiência de alfa 1-Antitripsina/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161210
[St] Status:MEDLINE


  9 / 1349 MEDLINE  
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[PMID]:27926404
[Au] Autor:Bazeboso JA; Tshilolo LM; Mbongo CL; Bilbao JI
[Ad] Endereço:Centre Hospitalier Monkole, Monkole, Kinshasa, Democratic Republic of Congo.
[Ti] Título:Partial Splenic Embolization in a Child with Sickle Cell Disease and Hypersplenism.
[So] Source:J Vasc Interv Radiol;27(11):1738-1739, 2016 Nov.
[Is] ISSN:1535-7732
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anemia Falciforme/complicações
Embolização Terapêutica/métodos
Esponja de Gelatina Absorvível/administração & dosagem
Hiperesplenismo/terapia
[Mh] Termos MeSH secundário: Anemia Falciforme/diagnóstico
Criança
Seres Humanos
Hiperesplenismo/diagnóstico por imagem
Hiperesplenismo/etiologia
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161208
[St] Status:MEDLINE


  10 / 1349 MEDLINE  
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[PMID]:27720430
[Au] Autor:Takahashi Y; Matsuura T; Yanagi Y; Yoshimaru K; Taguchi T
[Ad] Endereço:Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. Electronic address: yoshiaki@med.kyushu-u.ac.jp.
[Ti] Título:The role of splenectomy before liver transplantation in biliary atresia patients.
[So] Source:J Pediatr Surg;51(12):2095-2098, 2016 Dec.
[Is] ISSN:1531-5037
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/PURPOSE: There is currently no unified view regarding whether liver transplantation or splenectomy should be performed for hypersplenism before liver transplantation in biliary atresia (BA) patients. We herein describe the efficacy of splenectomy before liver transplantation. METHODS: Splenectomy was performed in ten patients with hypersplenism associated with BA. We retrospectively reviewed their perioperative and postoperative courses, the number of leukocytes and thrombocytes, and the MELD score. RESULTS: The mean age was 17.5±7.0years (range 11-31years), and the male-to-female ratio was 1:1. The platelet and leukocyte levels increased after splenectomy and returned to normal levels one month postoperatively. The mean MELD score after splenectomy was significantly decreased after splenectomy: 10±2.1 vs 7.6±1.8. In particular, PT-INR improved. Five patients underwent liver transplantation because of hepatopulmonary syndrome and repeated bouts of cholangitis, whereas the remaining five patients did not undergo liver transplantation because of improvements in the liver function (the mean follow-up period was 56months). The postoperative complications included portal vein thrombosis and intestinal perforation, but the patient survival rates remained at 100%. CONCLUSION: After splenectomy, both pancytopenia and the liver function clearly improved. Splenectomy should therefore be a treatment option for patients with hypersplenism before liver transplantation. LEVEL OF EVIDENCE: Retrospective Comparative Study - Level III.
[Mh] Termos MeSH primário: Atresia Biliar/cirurgia
Hiperesplenismo/complicações
Transplante de Fígado/métodos
Complicações Pós-Operatórias/prevenção & controle
Esplenectomia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Atresia Biliar/complicações
Criança
Feminino
Seres Humanos
Hiperesplenismo/cirurgia
Masculino
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE



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