Outcome of nonsurgical hepatic decompression in Budd-Chiari

Budd-Chiari syndrome (BCS) results from hepatic venous outflow obstruction at any level from hepatic venules to the right atrium. Few patients respond to medical treatment (anticoagulation ± thrombolytic therapy, diuretics). However, most patients need intervention to restore the hepatic blood flow. Restoring outflow in one of the major hepatic veins by balloon dilatation ± stenting is the management of choice. When not possible or failed, transjugular intrahepatic portosystemic shunt (TIPS) is used. Follow up of patients after radiological intervention is crucial in order to assess patient improvement, shunt patency and function and to manage any procedure related complications.

A research article published on February 21, 2011 in the World Journal of Gastroenterology addresses this question. In this study, the authors demonstrated that morbidity and mortality following angioplasty ± stenting and TIPS are low with satisfactory outcome. This study may represent a future strategy for good selection of procedure candidates, maintenance of shunt patency by strict adherence to anticoagulation and early management of shunt dysfunction which are all crucial in clinical, laboratory and radiological improvement of BCS patients.

Reference: Eldorry A, Barakat E, Abdella H, Abdelhakam S, Shaker M, Hamed A, Sakr M. Outcome of non surgical hepatic decompression procedures in Egyptian patients with Budd-Chiari. World J Gastroenterol 2011; 17(7): 906-913

http://www.wjgnet.com/1007-9327/full/v17/i7/906.htm

Correspondence to: Sara Abdelhakam, MD, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt. saratropical@yahoo.com

Telephone: +20-1-01601548 Fax: +20-2-22598751

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2009 IF: 2.092. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.