Prediction of therapeutic effect by BRTO for the patients with portosystemic shunt hepatic encepharopathy

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  • Matsui Teppei
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Nagai Hidenari
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Amanuma Makoto
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Yoshimine Naoyoshi
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Kobayashi Kojiro
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Ogino Yu
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Mukozu Takanori
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Matsukiyo Yasushi
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Wakui Noritaka
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University
  • Nakano Shigeru
    Division of Gastroenterology, Saiseikai Yokohamashi Tobu Hospital
  • Igarashi Yoshinori
    Division of Gastroenterology and Hepatology, Department of Internal Medicine Omori School of Medicine, Faculty of Medicine, Toho University

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Other Title
  • シャント型肝性脳症に対するバルーン閉塞下逆行性静脈塞栓術における効果予測の検討
  • シャントガタ カンセイ ノウショウ ニ タイスル バルーン ヘイソク カ ギャッコウセイ ジョウミャク ソクセンジュツ ニ オケル コウカ ヨソク ノ ケントウ

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Abstract

<p>Balloon occluded retrograde transvenous obliteration (BRTO) is effective for porto-systemic shunt hepatic encephalopathy (PSHE), although some patients have refractory to BRTO. We investigate the usefulness of BRTO for patients with PSHE. Nineteen patients with liver cirrhotic and PSHE were divided in two groups, group NE (recurred PSHE within 12 weeks after BRTO: n＝6) and group E (did not recur PSHE within 12 weeks: n＝13). We analyzed Child-Pugh score (CPS), serum ammonia (NH3), hepatic venous pressure gradient (HVPG) and skeletal muscle index (SMI). In group NE, HVPG was higher and SMI was lower significantly than group E. The patients HVPG over 12 mmHg tended early recur of PSHE compared with less 12 mmHg. The diagnostic capability for predicting therapeutic effectiveness of HVPG and SMI were satisfactory with area under the receiver operating characteristic curve (AUROC) of 0.91 (p＜0.001, 95%CI＝0.77-1.04), 0.84 (p＜0.001, 95%CI＝0.65-1.03). HVPG and SMI before BRTO might be useful factor for prediction of therapeutic effect.</p>

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