Surgical Portosystemic Shunts: History, Evolution, and Current Applications
| العنوان: | Surgical Portosystemic Shunts: History, Evolution, and Current Applications |
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| المؤلفون: | G. Peter Feola, Fidel Lopez-Verdugo, Zachary J. Kastenberg, Andrew Gagnon, Manuel I. Rodriguez-Davalos, Ivan Zendejas, Jorge Sanchez-Garcia |
| المصدر: | Digestive Disease Interventions. :157-167 |
| بيانات النشر: | Georg Thieme Verlag KG, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, Cirrhosis, business.industry, medicine.medical_treatment, Gastroenterology, Liver transplantation, medicine.disease, Venous Obstruction, Surgery, Transplantation, Liver disease, medicine, Portal hypertension, Radiology, Nuclear Medicine and imaging, Thrombus, business, Transjugular intrahepatic portosystemic shunt |
| الوصف: | Mechanical obstruction, thrombus, intrinsic liver disease causing fibrosis or cirrhosis, or an outflow obstruction at the level of the sinusoids or hepatic venous obstruction can cause an increase in pressure or resistance, or both, leading to portal hypertension (PH). Portosystemic shunts (PSS) are usually performed to relieve the congestion that inevitably occurs in the setting of PH. Since their introduction, surgical PSS were often the treatment of choice to prevent recurrent bleeding in patients with clinically significant PH. Development of novel pharmacological therapies, continuous improvement of endoscopic approaches, the introduction of transjugular intrahepatic portosystemic shunt, and advancements in transplantation has provided an evolution in the approach for PH and has precipitated the steady decrease in the proportion of patients needing surgical shunts. Despite this, PSS remain important tools in the surgeon's armamentarium, as they are often employed in the pediatric population with extrahepatic portal vein obstruction and are frequently being used for portal inflow modulation to achieve better portal hemodynamics in resections and transplantation. This has become of great relevance to decrease the risk of small-for-size syndrome and portal hyperperfusion in liver transplantation, and to decrease the risk of posthepatectomy liver dysfunction after major resections in hepatobiliary surgery. |
| تدمد: | 2472-873X 2472-8721 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::4a7e874ccc98a706e78dc876430ab409 https://doi.org/10.1055/s-0040-1713371 |
| رقم الأكسشن: | edsair.doi...........4a7e874ccc98a706e78dc876430ab409 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 2472873X 24728721 |
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