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[Hepatic encephalopathy after portosystemic shunt]
D Jentschura1, L W Storz, B Rumstadt
1Chirurgische Universitätsklinik Mannheim.
Langenbecks Archiv Fur Chirurgie
|January 1, 1996
Summary
Cirrhotic patients with porto-systemic shunts had elevated ammonia but no significant mental decline. Surgical shunts can effectively treat esophageal varices in select patients.
Area of Science:
- Gastroenterology
- Neurology
- Biochemistry
Context:
- Cirrhosis leads to porto-systemic shunts, impacting liver function and potentially causing hepatic encephalopathy.
- Assessing mental state and biochemical markers is crucial for understanding encephalopathy in cirrhotic patients.
Purpose:
- To compare mental state and biochemical parameters in cirrhotic patients with and without porto-systemic shunts.
- To evaluate the efficacy of porto-systemic shunts in managing esophageal varices and their impact on encephalopathy.
Summary:
- Cirrhotic patients with shunts showed elevated ammonia and altered amino acid levels but no clinical hepatic encephalopathy.
- Psychometric tests indicated subclinical encephalopathy in both shunted and non-shunted cirrhotic groups.
- Flicker photometry distinguished non-shunted cirrhotic patients from healthy controls.
Impact:
- Elevated ammonia levels in patients with porto-systemic anastomosis do not necessarily cause significant mental disturbance.
- Porto-systemic end-side shunts are an appropriate treatment for esophageal varices in well-selected cirrhotic patients.
- The study highlights the importance of subclinical encephalopathy assessment in cirrhotic patients.