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Unconventional shunt surgery for non-cirrhotic portal hypertension in patients not suitable for proximal splenorenal shunt

S L H, Pottakkat B, Gnanasekaran S, Raja K

Backgrounds/Aims: Proximal splenorenal shunt (PSRS) is a commonly performed procedure to decompress portal hypertension, in patients with refractory variceal bleed, especially in non-cirrhotic portal hypertension (NCPH). If conventional methods are...
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Spontaneous hepatic arterioportal fistula in extrahepatic portal vein obstruction: Combined endovascular and surgical management

Panda A, Narayanan D, Netaji A, Varshney VK, Agarwal L, Garg PK

Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular...
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Safety and efficacy of splenic artery embolization for the treatment of gastric variceal bleeding secondary to left-sided portal hypertension

Lee SY, Kim KR, Commander C

Background: Left-sided portal hypertension (LPH) is an uncommon clinical condition resulting from splenic vein stenosis/occlusion, which may cause bleeding from gastric varices. This study reviewed the long-term safety and efficacy...
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The Role of Endoscopic Ultrasound in Hepatology

Alqahtani SA, Ausloos F, Park JS, Jang S

Endoscopic ultrasound (EUS) has been an indispensable and widely used diagnostic tool in several medical fields, including gastroenterology, cardiology, and urology, due to its diverse therapeutic and diagnostic applications. Many...
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Endoscopic ultrasound-guided coiling and glue is safe and superior to endoscopic glue injection in gastric varices with severe liver disease: a retrospective case control study

Jamwal KD, Padhan RK, Sharma A, Sharma MK

Background/Aims: Gastric varices (GV) are present in 25% of cirrhotic patients with high rates of rebleeding and mortality. Data on endoscopic ultrasound (EUS)-guided treatment in severe liver disease (model for...
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Baveno VII criteria to predict decompensation in compensated advanced chronic liver disease: Still some shades of grey

Rodrigues SG

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Baveno-VII criteria to predict decompensation and initiate non-selective beta-blocker in compensated advanced chronic liver disease patients

Wong YJ, Zhaojin C, Tosetti G, Degasperi E, Sharma S, Agarwal S, Chuan L, Huak CY, Jia L, Xiaolong Q, Saraya A, Primignani M

Background/Aims: The utility of Baveno-VII criteria of clinically significant portal hypertension (CSPH) to predict decompensation in compensated advanced chronic liver disease (cACLD) patient needs validation. We aim to validate the...
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Use of caudal pancreatectomy as a novel adjunct procedure to proximal splenorenal shunt in patients with noncirrhotic portal hypertension: A retrospective cohort study

Gupta S, Pottakkat B, Kalayarasan R, Senthil G, Balaji Nitesh PN

Backgrounds/Aims: Proximal splenorenal shunt (PSRS) is considered a one-time treatment for noncirrhotic portal hypertension (NCPH) to prevent recurrent upper gastrointestinal (UGI) hemorrhage and long-term complications. Long-term shunt patency is necessary...
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Refractory Ascites with Intrahepatic Portal Thrombosis after Living Donor Liver Transplantation Successfully Treated by Splenic Artery Embolization and Apixaban (Case Report)

Moon HH

Refractory ascites is a rare complication after liver transplantation, and its incidence ranges from 5% to 7%. A 56-yearold man diagnosed with HBV-LC with massive ascites underwent living donor liver...
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Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults

Namgoong JM, Hwang S, Ahn CS, Moon DB, Ha TY, Song GW, Jung DH, Park GC, Yoon YI, Kim KM, Lee SG

Background: Some young adults have a long survival period with native liver after Kasai portoenterostomy (KPE) for biliary atresia (BA). However, a considerable proportion of these patients require liver transplantation...
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Diagnosis and Management of Esophageal and Gastric Variceal Bleeding: Focused on 2019 KASL Clinical Practice Guidelines for Liver Cirrhosis

Park MK, Lee YB

Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis complications have a poor prognosis and require...
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β-blockers in advanced cirrhosis: More friend than enemy

Yoon KT, Liu H, Lee SS

Nonselective beta-adrenergic blocker (NSBB) therapy for the prevention of initial and recurrent gastrointestinal bleeding in cirrhotic patients with gastroesophageal varices has been used for the past four decades. NSBB therapy...
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Recurrent Bleeding From Ileal Conduit Stomal Varices in a Patient With Portal Hypertension

Chung JW, Ha YS, Lee JN, Kim TH, Kwon TG

Bleeding from ileal conduit stomal varices is a rare complication. The standard treatment for the management of stomal varices has not been established yet. We present the case of a...
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Non-cirrhotic portal hypertension related to azathioprine therapy in a patient with Crohn’s disease

Seo JW, Kim ES, Han MH, Kweon YO

Azathioprine is widely used for the treatment of Crohn’s disease (CD). Few cases from Western countries have reported idiopathic non-cirrhotic portal hypertension (NCPH) related to thiopurine therapy in patients with...
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Pediatric liver transplantation using a hepatitis B surface antigen-positive donor liver graft for congenital absence of the portal vein

Namgoong JM, Hwang S, Kim DY, Ha TY, Song GW, Jung DH, Kim KM, Oh SH

Congenital absence of the portal vein (CAPV) is a rare venous malformation in which mesenteric venous blood drains directly into systemic circulation. Herein, we report a case of pediatric deceased...
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The cutoff of transient elastography for the evaluation of portal hypertension should be different according to the etiology?

Kim BK

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Noninvasive markers for esophageal varices in children with cirrhosis

Rahmani P, Farahmand F, Heidari G, Sayarifard A

Background: The diagnosis of esophageal varices (EV) is based on the findings of esophagogastroduodenoscopy (EGD), biopsy, and serum markers. Thus, noninvasive cost-effective tests through which high-risk EV children can be...
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Standard or Variant Meso-Rex Shunts for Children with Variceal Bleeding due to Extrahepatic Portal Vein Obstruction: A Report of Two Cases

Oh MY, Kim HK, Han A, Yi NJ, Min SK

Extrahepatic portal vein obstruction (EHPVO) is the most common cause of pediatric portal hypertension and can cause life-threatening variceal bleeding. MesoRex shunt (MRS) is a surgical procedure that restores physiological...
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Prolonged hepatic inflow occlusion to reduce bleeding during recipient hepatectomy in living donor liver transplantation

Choi JU, Hwang S, Chung IJ, Kang SH, Ahn CS, Moon DB, Ha TY, Kim KH, Song GW, Jung DH, Park GC, Yoon YI, Cho HD, Lee SG

Background: Living donor liver transplantation (LDLT) causes bleeding in recipients during the careful preservation of most perihilar structures during this surgery. This case-control study aimed to analyze the effect of...
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The New Cutoff Value of the Hepatic Venous Pressure Gradient on Predicting Long-Term Survival in Cirrhotic Patients

Kim TY, Suk KT, Jeong SW, Ryu T, Kim DJ, Baik SK, Sohn JH, Jeong WK, Choi E, Jang JY, Kim MY

BACKGROUND: This study aimed to determine the prognostic role of the categorized hemodynamic stage (HS) based on the hepatic venous pressure gradient (HVPG) in patients with portal hypertension. METHODS: Of 1,025...
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