The Experts below are selected from a list of 33 Experts worldwide ranked by ideXlab platform
I Made Mulyawan - One of the best experts on this subject based on the ideXlab platform.
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Combination of modified Sugiura technique and proximal splenorenal shunt for the management of portal vein thrombosis in noncirrhotic portal hypertension
Clinical and experimental gastroenterology, 2019Co-Authors: Hendry Irawan, I Made MulyawanAbstract:Background: Noncirrhotic portal hypertension (NCPH) is a condition when a high hepatic venous pressure gradient with preserved liver functions and the absence of parenchymal dysfunction. NCPH with portal vein thrombosis (PVT) is a rare condition. Surgery aims to reduce portal vein flow and alter portal vein circulation. Case: A male, 59 years old, complained of blackish stool in the last 2 weeks and enlarged abdomen. Physical examination revealed anemia and melena with splenomegaly and ascites. Laboratory findings were anemia, normal hepatobiliary function, and no liver infection. Abdominal Doppler ultrasonography and contrast-enhanced abdominal computed tomography scan revealed ascites, splenomegaly, noncirrhotic liver, dilatation of portal vein, low portal vein peak velocity, and PVT. Esophagogastroduodenoscopy revealed esophageal Varices grade 3 with a positive red color sign and cardia Stomach Varices. We performed a modified Sugiura technique through the left subcostal incision and proximal splenorenal shunt. The procedures of the modified Sugiura technique are splenectomy, devascularization, transection, and end-to-end anastomosis of the lower esophagus above the gastroesophageal junction, devascularization of the upper 2/3 of the lesser and greater curvatures of the Stomach, and pyloroplasty. Portal circulation alteration used the proximal splenorenal shunt with end-to-side anastomosis of the splenic vein to left renal vein. At the one-year follow-up after surgery, his physical condition was better and there was no sign of complications. Conclusion: Devascularization procedure using a modified Sugiura technique is useful to treat and avoid rupture of esophageal Varices. Portal circulation alteration using the proximal splenorenal shunt is a good choice. The treatment in NCPH utilizing the combination of modified Sugiura technique and the proximal splenorenal shunt is proper without complication.
Hendry Irawan - One of the best experts on this subject based on the ideXlab platform.
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Combination of modified Sugiura technique and proximal splenorenal shunt for the management of portal vein thrombosis in noncirrhotic portal hypertension
Clinical and experimental gastroenterology, 2019Co-Authors: Hendry Irawan, I Made MulyawanAbstract:Background: Noncirrhotic portal hypertension (NCPH) is a condition when a high hepatic venous pressure gradient with preserved liver functions and the absence of parenchymal dysfunction. NCPH with portal vein thrombosis (PVT) is a rare condition. Surgery aims to reduce portal vein flow and alter portal vein circulation. Case: A male, 59 years old, complained of blackish stool in the last 2 weeks and enlarged abdomen. Physical examination revealed anemia and melena with splenomegaly and ascites. Laboratory findings were anemia, normal hepatobiliary function, and no liver infection. Abdominal Doppler ultrasonography and contrast-enhanced abdominal computed tomography scan revealed ascites, splenomegaly, noncirrhotic liver, dilatation of portal vein, low portal vein peak velocity, and PVT. Esophagogastroduodenoscopy revealed esophageal Varices grade 3 with a positive red color sign and cardia Stomach Varices. We performed a modified Sugiura technique through the left subcostal incision and proximal splenorenal shunt. The procedures of the modified Sugiura technique are splenectomy, devascularization, transection, and end-to-end anastomosis of the lower esophagus above the gastroesophageal junction, devascularization of the upper 2/3 of the lesser and greater curvatures of the Stomach, and pyloroplasty. Portal circulation alteration used the proximal splenorenal shunt with end-to-side anastomosis of the splenic vein to left renal vein. At the one-year follow-up after surgery, his physical condition was better and there was no sign of complications. Conclusion: Devascularization procedure using a modified Sugiura technique is useful to treat and avoid rupture of esophageal Varices. Portal circulation alteration using the proximal splenorenal shunt is a good choice. The treatment in NCPH utilizing the combination of modified Sugiura technique and the proximal splenorenal shunt is proper without complication.
Irawa H - One of the best experts on this subject based on the ideXlab platform.
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Combination of modified Sugiura technique and proximal splenorenal shunt for the management of portal vein thrombosis in noncirrhotic portal hypertension
Dove Medical Press, 2019Co-Authors: Irawa HAbstract:Hendry Irawan,1 I Made Mulyawan21General Surgery Department, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia; 2Digestive Surgery Division, General Surgery Department, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, IndonesiaBackground: Noncirrhotic portal hypertension (NCPH) is a condition when a high hepatic venous pressure gradient with preserved liver functions and the absence of parenchymal dysfunction. NCPH with portal vein thrombosis (PVT) is a rare condition. Surgery aims to reduce portal vein flow and alter portal vein circulation.Case: A male, 59 years old, complained of blackish stool in the last 2 weeks and enlarged abdomen. Physical examination revealed anemia and melena with splenomegaly and ascites. Laboratory findings were anemia, normal hepatobiliary function, and no liver infection. Abdominal Doppler ultrasonography and contrast-enhanced abdominal computed tomography scan revealed ascites, splenomegaly, noncirrhotic liver, dilatation of portal vein, low portal vein peak velocity, and PVT. Esophagogastroduodenoscopy revealed esophageal Varices grade 3 with a positive red color sign and cardia Stomach Varices. We performed a modified Sugiura technique through the left subcostal incision and proximal splenorenal shunt. The procedures of the modified Sugiura technique are splenectomy, devascularization, transection, and end-to-end anastomosis of the lower esophagus above the gastroesophageal junction, devascularization of the upper 2/3 of the lesser and greater curvatures of the Stomach, and pyloroplasty. Portal circulation alteration used the proximal splenorenal shunt with end-to-side anastomosis of the splenic vein to left renal vein. At the one-year follow-up after surgery, his physical condition was better and there was no sign of complications.Conclusion: Devascularization procedure using a modified Sugiura technique is useful to treat and avoid rupture of esophageal Varices. Portal circulation alteration using the proximal splenorenal shunt is a good choice. The treatment in NCPH utilizing the combination of modified Sugiura technique and the proximal splenorenal shunt is proper without complication.Keywords: modified Sugiura technique, proximal splenorenal shunt, portal vein thrombosis, noncirrhotic portal hypertensio
Wu Jinming - One of the best experts on this subject based on the ideXlab platform.
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Comparison of TH glue perfusing embolization through PTVE and TH glue perfusing embolization through endoscope
Chinese Journal of Gastroenterology and Hepatology, 2013Co-Authors: Wu JinmingAbstract:Objective To investigate the feasibility and efficacy of percutaneous transhepatic Varices(PTVE) embolization of gastroesophageal Varices combined with partial splenic emboliaztion(PSE) in gastroesophageal Varices bleeding.Methods 150 cases of portal hypertension and rupture of esophago-fundus of Stomach Varices were divided into two groups.One group was TH glue perfusing embolization through PTVE+PSE partial splenic embolization,the other group was TH glue perfusing embolization by endoscope.Results This operation was successfull in all patients,hemostasia rate was 100%.Among three years of the follow-up,the group's rebleeding rate with PTVE was 25.00%,and the other group was 53.24%.Conclusion PTVE is safer,less trauma,higher hemostasia rate,lower rebleeding rate,so it is a rational treatment for portal hypertension and esophago-fundus of Stomach varicosity.
D O Davydov - One of the best experts on this subject based on the ideXlab platform.
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minimal invasive treatment of bleeding of esophagus and Stomach Varices in patients with portal hypertension
Experimental & clinical gastroenterology, 2010Co-Authors: V F Zubritskiĭ, M V Zabelin, A A Salnikov, M A Konenkova, D O DavydovAbstract:The results of examination and treatment of 57 patients with liver cirrhosis and portal hypertension with bleeding from the Varices of the esophagus and Stomach, admitted in the Clinical Hospital No 29 named after N.E. Bauman in Moscow. The Studies show that the efficiency of the radio-endovascular embolization for bleeding Varices of the esophagus and the Stomach is 89,5% of patients.The use of prolonged infusions of vasoconstrictors in combination with venous embolization helps further reduce portal hypertension and has a hemostatic effect in 10.5% of patients. The study shows the therapeutic tactic in bleeding Varices of the esophagus and the Stomach should be individualized and based on clinical-endoscopic prediction of rebleeding according to the severity of blood loss and patient's condition.