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J Pediatr Surg 2020 May 23. Epub 2020 May 23.

Department of Pediatric Surgery, Lilavati Hospital & Research Centre, Mumbai.

Introduction: Budd-Chiari syndrome (BCS) is a rare condition affecting children. It is characterized by occlusion of venous outflow from liver at the level of hepatic veins (HV) or inferior vena cava (IVC). The management of BCS in children revolves around forming new collaterals for venous outflow or by elimination of blockage in the venous outflow tracts. Read More

JHEP Rep 2020 Jun 9;2(3):100097. Epub 2020 Mar 9.

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Background & Aims: Hepatobiliary phase (HBP) images can discriminate between benign and malignant liver lesions, but it is unclear if this approach can be used in patients with Budd-Chiari syndrome (BCS). Thus, we aimed to assess the diagnostic utility of HBP images in patients with BCS.

Methods: This retrospective study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MR imaging (HBCA-MRI) from 2000 to 2019. Read More

World J Gastrointest Endosc 2020 Mar;12(3):83-97

Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.

Liver biopsy (LB) is an essential tool in diagnosing, evaluating and managing various diseases of the liver. As such, histopathological results are critical as they establish or aid in diagnosis, provide information on prognosis, and guide the appropriate selection of medical therapy for patients. Indications for LB include evaluation of persistent elevation of liver chemistries of unclear etiology, diagnosis of chronic liver diseases such as Wilson's disease, autoimmune hepatitis, small duct primary sclerosing cholangitis, work up of fever of unknown origin, amyloidosis and more. Read More

Int J Surg Case Rep 2020 9;68:251-256. Epub 2020 Mar 9.

Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong Special Administrative Region. Electronic address:

Background And Aims: Infiltration of hepatic venous outflow in hepatic alveolar echinococcosis can lead to development of Budd-Chiari syndrome. Medical treatment of this condition is generally unsatisfactory. Radical hepatic resection is impossible for extensive parasitic involvement of liver. Read More

Radiographics 2020 Mar-Apr;40(2):562-588

From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.).

US is a powerful and nearly ubiquitous tool in the practice of interventional radiology. Use of contrast-enhanced US (CEUS) has gained traction in diagnostic imaging given the recent approval by the U.S. Read More

Curr Opin Gastroenterol 2020 May;36(3):184-191

Department of Internal Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

Purpose Of Review: Over the past decade, imaging modalities and serological tests have emerged as important tools in the evaluation of liver diseases, in many cases supplanting the use of liver biopsy and histological examination. Nonetheless, the accuracy and diagnostic value of these methods may not always be conclusive and the assessment of liver histology often remains the gold standard for diagnostic evaluation. The purpose of this review is to summarize the current role of liver biopsy in contemporary hepatology practice. Read More

Zhonghua Yi Xue Za Zhi 2020 Feb;100(5):387-390

Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt(TIPS) for the treatment of patients with cavernous transformation of portal vein (CTPV) with vareceal bleeding. From September 2016 to June 2018, a total of 21 patients suffered CTPV complicated with vareceal bleeding were admitted to First Affiliated Hospital of Zhengzhou University. TIPS were performed combined with percutaneous transhepatic portal vein assist. Read More

J Am Heart Assoc 2020 01 4;9(1):e012529. Epub 2020 Jan 4.

Division of Cardiology Department of Pediatrics British Columbia Children's Hospital and University of British Columbia Vancouver British Columbia Canada.

Background Information is evolving on liver disease in pediatric patients with Fontan physiology. The purpose of this investigation is to evaluate the spectrum of liver disease in a pediatric population of patients with Fontan physiology and evaluate transient elastography (TE) as a noninvasive marker of liver disease. Methods and Results We prospectively enrolled all children with Fontan physiology. Read More

Ann Hepatol 2019 Dec 3. Epub 2019 Dec 3.

Liver Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy.

A 39-year-old female, liver transplanted for Autosomic Dominant Polycystic Kidney Disease (ADPKD) developed refractory ascites early after surgery, with frequent need of large-volume paracentesis. This was associated with severe sarcopenia and kidney impairment. Liver biopsy showed a sinusoidal congestion with a significant enlargement of hepatic portal veins. Read More

J Pediatr Gastroenterol Nutr 2020 Apr;70(4):417-422

Department of Pediatric Gastroenterology.

Background/objective: Percutaneous biopsy (PB) and transjugular liver biopsy (TJLB) are 2 main ways of obtaining liver tissue. We evaluated the indications, success rate, tissue yield, and complications of TJLB in comparison to PB in children.

Methods: Electronic records of children undergoing liver biopsy (LB) were reviewed. Read More

J Nepal Health Res Counc 2019 Nov 13;17(3):357-361. Epub 2019 Nov 13.

Department of Medicine, Liver Unit, Bir hospital, Kathmandu, Nepal.

Background: The clinical picture in cirrhosis is dominated by the classical complications such as ascites, bleeding varices, portal hypertension and encephalopathy. Cardiac dysfunction in patients with cirrhosis, which contributes significantly to the morbidity and, mortality though prevalent, is less studied and not widely recognized entity since it is largely asymptomatic at rest, with overt heart failure seen mainly during pharmacological stress, transjugular intrahepatic portosystemic shunt, liver transplantation.

Methods: It is a cross sectional study done on patients admitted in wards or attending to outpatient department of Liver unit, Bir Hospital, between May 2015 to May 2016. Read More

Zhonghua Gan Zang Bing Za Zhi 2019 10;27(10):799-801

Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.

Dig Dis Sci 2020 Jul 13;65(7):2104-2111. Epub 2019 Nov 13.

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Background And Aim: Hemostasis in cirrhosis is dynamic and balanced. Thromboelastography (TEG) assesses global coagulation status. We aimed to assess whether TEG-guided blood product transfusions result in lower blood product requirements in patients with cirrhosis undergoing invasive liver-related procedures as compared to the conventional standard of care (SOC). Read More

ACG Case Rep J 2019 Jul 2;6(7):e00121. Epub 2019 Jul 2.

Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom.

Budd-Chiari syndrome is a rare disorder with significant liver-related complications. We present a 28-year-old woman with a 1-month history of weight loss and ascites. Hepatic venogram showed patent hepatic veins and inferior vena cava; however, there was an increased hepatic venous pressure gradient, which is clinically significant for portal hypertension. Read More

World J Gastroenterol 2019 Aug;25(31):4437-4451

Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome 00168, Italy.

Portal vein thrombosis (PVT) represents a well-known complication during the natural course of liver cirrhosis (LC), ranging from asymptomatic cases to life-threating conditions related to portal hypertension and hepatic decompensation. Portal flow stasis, complex acquired hypercoagulable disorders and exogenous factors leading to endothelial dysfunction have emerged as key factors for PVT development. However, PVT occurrence remains unpredictable and many issues regarding its natural history, prognostic significance and treatment are still elusive. Read More

Aliment Pharmacol Ther 2019 11 5;50(9):1049-1058. Epub 2019 Sep 5.

The Royal Free Sheila Sherlock Liver Centre, Royal Free London NHS Trust, London, UK.

Background: Anticoagulation alone in acute, extensive portomesenteric vein thrombosis (PVT) does not always result in spontaneous clot lysis, and leaves the patient at risk of complications including intestinal infarction and portal hypertension.

Aim: To develop a new standard of care for patients with acute PVT and evidence of intestinal ischaemia.

Methods: We present a case series of patients with acute PVT and evidence of intestinal ischaemia plus ongoing symptoms despite initial systemic anticoagulation, who were treated with a thrombolysis protocol between 2014 and 2019. Read More

J Clin Med 2019 Aug 17;8(8). Epub 2019 Aug 17.

Digestive Disease Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain.

Background: we aimed to assess the influence of metabolic syndrome on fibrosis regression (using liver-stiffness measurement (LSM) and serological scores) and the relationship with the expression of lysyl oxidase-like-2 as a potential goal of antifibrotic therapy.

Methods: We included 271 patients treated with Direct Antiviral Therapy (DAAs) in our hospital who achieved a sustained virological response (SVR); physical examination, blood tests, and LSM were made at baseline (B) and 24 months (24 M) after SVR. Hemodynamic studies and transjugular liver biopsies were performed on 13 patients. Read More

World J Gastroenterol 2019 Jul;25(28):3753-3763

Division of Gastroenterology, Union Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.

Hepatic sinusoidal obstruction syndrome (HSOS) can be caused by the intake of pyrrolizidine alkaloids (PAs). To date, PAs-induced HSOS has not been extensively studied. In view of the difference in etiology of HSOS between the West and China, clinical profiles, imaging findings, treatment, and outcomes of HSOS associated with hematopoietic stem cell transplantation or oxaliplatin might be hardly extrapolated to PAs-induced HSOS. Read More

Cardiovasc Intervent Radiol 2019 Nov 5;42(11):1545-1550. Epub 2019 Aug 5.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.

Purpose: To evaluate the efficacy and safety of transjugular liver biopsy in pediatric patients with left lobe or lateral segment liver transplant.

Materials And Methods: This was a retrospective study of data from 104 transjugular liver biopsies (57 children) using an 18- or 19-G biopsy needle. Transjugular liver biopsy was selected due to coagulopathy and/or ascites in 56 (54%) procedures. Read More

J Clin Exp Hepatol 2019 May-Jun;9(3):409-411. Epub 2018 Sep 12.

Department of Gastroenterology (Hepatology Unit), Hospital Clínico San Carlos, Madrid, Spain.

We herein report a rather peculiar case of acute liver injury. A 78-year-old woman developed asthenia and weakness. Her previous medical history was irrelevant, except for having received etoricoxib 60 mg/24 h for osteoarthritis 1 month before. Read More

Semin Liver Dis 2019 11 4;39(4):502-512. Epub 2019 Jul 4.

Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

The aim of this study was to evaluate the morphologic appearance, the clinical scenario, and the outcomes of patients with portal hypertensive biliopathy (PHB), particularly in the symptomatic subgroup treated with interventional radiology (IR) procedures. The outcome of 20 patients with PHB were retrospectively reviewed over a 5-year period. In all cases, the extrahepatic portal vein occlusion (EHPVO) and the compensatory cavernomatosis was the cause of PHB. Read More

Clin Transl Gastroenterol 2019 07;10(7):e00063

Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

Objectives: To investigate the safety profile and diagnostic efficacy of transjugular liver biopsy (TJLB), with a focus on patients with severe coagulopathies and with multiple biopsies.

Methods: Clinical, laboratory, and demographic information was collected on 1,321 TJLBs in 932 patients (mean age 43.5 ± 23. Read More

Intern Med 2019 Oct 27;58(20):2969-2975. Epub 2019 Jun 27.

Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Japan.

A 72-year-old Japanese man was referred to our hospital with yellow discoloration of the sclera and liver dysfunction. He was diagnosed with acute hepatitis C virus (HCV) infection on the basis of HCV-RNA positivity and anti-HCV seroconversion. A transjugular liver biopsy confirmed submassive hepatic necrosis. Read More

BMJ Case Rep 2019 May 28;12(5). Epub 2019 May 28.

Gastroenterology, Ernakulam Medical Centre, Kochi, Kerala, India.

We present a teetotaler with compensated non-alcoholic fatty-liver-disease related cirrhosis who presented with acute worsening of his chronic liver disease. The acute event was not discernible even after extensive work up and finally a transjugular liver biopsy revealed features suggestive of severe alcoholic hepatitis. The patient and the family denied occult alcohol use when questioned over multiple times and finally, the culprit 'alcohol' was found to be the homoeopathy medicines that the patient was consuming over a month for treatment of Gilbert's syndrome. Read More

Tech Vasc Interv Radiol 2019 Jun 27;22(2):87-92. Epub 2019 Feb 27.

Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY. Electronic address:

Radioembolization has become a more prevalent treatment for both primary and secondary liver of the liver. Radioembolization is a relatively safe procedure with major complications being rare. Understanding how to identify the potential complications and their treatment can help make the procedure even safer and mitigate the risk of severe life threatening complications. Read More

Dig Liver Dis 2019 08 1;51(8):1152-1153. Epub 2019 May 1.

Liver and Digestive ICU, Liver Unit, Hospital Clínic of Barcelona, Spain. Electronic address:

Ann Hepatol 2019 May - Jun;18(3):518-535. Epub 2019 Apr 18.

Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Liver Research Center, Pittsburgh, PA, USA. Electronic address:

Alcohol-related liver disease (ALD) is a major cause of advanced chronic liver disease in Latin-America, although data on prevalence is limited. Public health policies aimed at reducing the alarming prevalence of alcohol use disorder in Latin-America should be implemented. ALD comprises a clinical-pathological spectrum that ranges from steatosis, steatohepatitis to advanced forms such as alcoholic hepatitis (AH), cirrhosis and hepatocellular carcinoma. Read More

Congenit Heart Dis 2019 Jul 30;14(4):600-608. Epub 2019 Apr 30.

Division of Pediatric Cardiology, University of California San Diego and Rady Children's Hospital, USA.

Introduction: Liver fibrosis and cirrhosis are late complications in Fontan palliation. Liver biopsy is the gold standard. The goal of this study is to correlate transjugular liver biopsy (TJLB) in the setting of Fontan palliation with noninvasive testing and hemodynamics. Read More

Eur J Radiol 2019 Apr 31;113:15-23. Epub 2019 Jan 31.

Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195, USA. Electronic address:

Hepatic capsular retraction is a morphologic descriptor that refers to invagination or focal flattening of the typical smooth contour of the liver capsule. It is an uncommon finding that, when combined with other imaging features and clinical context, can help to refine the differential diagnosis in patients with liver lesions. Although this descriptor has historically been used in reference to a small subset of benign and malignant lesions, the differential has since been expanded with the discovery of new entities causing capsular retraction as well as with novel and increased use of liver-directed treatment techniques. Read More

J Pediatr Gastroenterol Nutr 2019 06;68(6):788-792

Center for Clinical and Translational Research, Seattle Children's Research Institute.

Objectives: In adults, elevated hepatic venous pressure gradients (HVPGs) are correlated with the degree of liver fibrosis on histopathology and predict worse outcomes including variceal bleeding and death. We aimed to examine the association between HVPG measurements, histopathologic findings, and clinical indicators of portal hypertension in children.

Methods: Utilizing retrospective data from 2 pediatric centers between 2006 and 2015, we identified children who underwent simultaneous HVPG measurement and transjugular liver biopsy. Read More

Chin Med J (Engl) 2019 May;132(9):1087-1099

Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100005, China.

Background: Portosystemic shunts, including surgical portosystemic shunts and transjugular intra-hepatic portosystemic shunt (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.

Methods: Using the terms "variceal hemorrhage or variceal bleeding or variceal re-bleeding" OR "esophageal and gastric varices" OR "portal hypertension" and "liver cirrhosis," the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Read More

Clin Mol Hepatol 2019 06 22;25(2):210-217. Epub 2019 Mar 22.

Department of Infectious Disease, the First Affiliated Hospital of Anhui Medical University, Hefei, China.

Background/aims: In recent years, greater assessment accuracy after transjugular intrahepatic portosystemic shunt (TIPS) to ascertain prognosis has become important in decompensated cirrhosis due to portal hypertension. The aim of this study was to assess the ratio of the portal pressure gradient (PPG) pre-TIPS (pre-PPG) to albumin (PPA), which influence ascites formation in cirrhotic patients in the 6-months after TIPS placement, and is a metric introduced in our study.

Methods: This was a retrospective cohort study of 58 patients with decompensated cirrhosis admitted to an academic hospital for the purpose of TIPS placement. Read More

Expert Rev Gastroenterol Hepatol 2019 May 21;13(5):463-484. Epub 2019 Mar 21.

a Department of Medical and Surgical Sciences (DIMEC) , University of Bologna , Bologna , Italy.

Introduction: Veno-occlusive-disease (VOD), known also as sinusoidal-obstruction-syndrome (SOS), is one of the main complications of haematopoietic stem cell transplantation and is related to the treatment with pyrrolizidine alkaloids or other toxic agents (chemotherapy for liver-metastasis). Clinical diagnosis using the recent criteria from the European Society for Blood and Marrow Transplantation, is the reference for VOD/SOS diagnosis. However, increasing evidence suggests the emerging role of several imaging methods that could help the clinician in VOD/SOS assessment. Read More

Dig Liver Dis 2019 08 12;51(8):1144-1151. Epub 2019 Feb 12.

Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address:

Background: Transjugular liver biopsy (TJLB) represents an alternative to percutaneous liver biopsy especially in patients with impaired coagulation and ascites.

Aims: To describe safety and diagnostic yield of aspiration TJLB performed by hepatologists experienced in hepatic venous pressure gradient (HVPG) measurements.

Methods: 445 TJLB of 399 patients between 01/2007-12/2016 were retrospectively assessed. Read More

Gastrointest Endosc Clin N Am 2019 Apr 2;29(2):173-186. Epub 2019 Feb 2.

Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 North Academy Avenue, 21-11, Danville, PA 17822, USA. Electronic address:

There remains an important role for liver biopsy in the management of liver disorders. Image-guided liver biopsy can be obtained with percutaneous or transjugular approaches. Real-time image-guided liver biopsy can be accomplished with endoscopic ultrasound (EUS). Read More

Aliment Pharmacol Ther 2019 04 3;49(7):840-863. Epub 2019 Mar 3.

Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Background: Budd-Chiari syndrome (BCS) is a rare but fatal disease caused by obstruction in the hepatic venous outflow tract.

Aim: To provide an update of the pathophysiology, aetiology, diagnosis, management and follow-up of BCS.

Methods: Analysis of recent literature by using Medline, PubMed and EMBASE databases. Read More

Aliment Pharmacol Ther 2019 04 28;49(7):926-939. Epub 2019 Feb 28.

Department of Liver Diseases and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.

Background: In patients with idiopathic non-cirrhotic portal hypertension (INCPH), the usual recommended strategy for management of variceal bleeding is the same as that in cirrhosis. However, this policy has been challenged by the different natural history between INCPH and cirrhosis.

Aim: To compare outcomes after transjugular intrahepatic portosystemic shunt (TIPSS) between INCPH and cirrhotic patients admitted for variceal bleeding. Read More

J Vasc Interv Radiol 2019 Jul 14;30(7):1043-1047. Epub 2019 Feb 14.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-361, San Francisco, CA 94143.

Purpose: To evaluate efficacy and safety of transjugular liver biopsy (TJLB) via the left hepatic vein in patients with left lobe-only liver transplants (LLOTs).

Materials And Methods: Retrospective review revealed 43 TJLBs performed in 26 patients with LLOTs (mean age 51.3 y; range, 18-73 y) between January 2009 and June 2016 at a single institution. Read More

Dig Liver Dis 2019 06 22;51(6):826-830. Epub 2019 Jan 22.

Division of Gastroenterology, Oregon Health & Science University, Portland, OR, United States. Electronic address:

Background: Liver biopsy through endoscopic ultrasound (EUS) has become a novel approach for tissue acquisition. We aim to evaluate the adequacy of EUS-guided liver biopsies in comparison to those obtained through interventional radiology (IR) techniques.

Methods: A retrospective single-center analysis was performed of all IR (transjugular or image-guided percutaneous) and EUS-guided liver biopsies performed at an academic medical center from January 2016 to January 2018. Read More

Can J Gastroenterol Hepatol 2019 2;2019:1673197. Epub 2019 Jan 2.

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy.

Aims: Budd-Chiari Syndrome (BCS) is a rare vascular disease of the liver caused by the obstruction of the hepatic venous outflow located from the small hepatic venules up to the entrance of the inferior vena cava (IVC) into the right atrium. Current prognostic indexes are suboptimal for an individual prognostic assessment and subsequent management of patients with BCS. Liver (LSM) and spleen (SSM) stiffness measurements are widely validated prognostic tools in hepatology, but the evidence in patients with BCS is limited. Read More

J Pediatr Gastroenterol Nutr 2019 04;68(4):e71

Lucile Packard Children's Hospital, Stanford, CA.

J Pediatr Gastroenterol Nutr 2019 04;68(4):e71

Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

Travel Med Infect Dis 2019 Jul - Aug;30:130-132. Epub 2019 Jan 11.

I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.

Case Reports Hepatol 2018 9;2018:5305691. Epub 2018 Dec 9.

Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan, Fukuoka 814-0180, Japan.

Patients with autoimmune hepatitis (AIH) may sometimes have concomitant idiopathic thrombocytopenic purpura (ITP). Severe thrombocytopenia in ITP interferes with percutaneous liver biopsy for pathological diagnosis of AIH. Here, we report a case of AIH with ITP in a 63-year-old woman. Read More

Eur J Gastroenterol Hepatol 2019 05;31(5):626-632

Hepatology and Liver Transplant Unit, Department of Medical Area (DAME).

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) is adopted to treat refractory complications of portal hypertension, such as variceal bleeding and ascites. This study aimed to assess predictors of hepatic encephalopathy (HE) development and cumulative transplant-free survival after TIPS placement in patients with cirrhosis complicated by refractory ascites and major gastroesophageal bleeding.

Materials And Methods: Sixty-three cirrhotic patients who underwent TIPS positioning as a secondary prophylaxis of major upper gastroesophageal bleeding (N=30) or to control refractory ascites (N=33) were enrolled. Read More

World J Gastrointest Endosc 2018 Nov;10(11):326-339

Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute, Lucknow 226014, Uttar Pradesh, India.

The liver has eight segments, which are referred to by numbers or by names. The numbering of the segments is done in a counterclockwise manner with the liver being viewed from the inferior surface, starting from Segment I (the caudate lobe). Standard anatomical description of the liver segments is available by computed tomographic scan and ultrasonography. Read More

Aliment Pharmacol Ther 2019 01 18;49(1):20-30. Epub 2018 Nov 18.

Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Department of Biomedical Research, University of Bern, Berne, Switzerland.

Background: Transjugular intrahepatic portosystemic shunt has been increasingly used in patients with portal vein thrombosis to obtain patency, but evidenced-based decisions are challenging.

Aim: To evaluate published data on efficacy and safety of endovascular therapy in portal vein thrombosis.

Methods: Systematic search of PubMed, ISI, Scopus, and Embase for studies (in English, until October 2017) reporting feasibility, safety, 12-month portal vein recanalisation, transjugular intrahepatic portosystemic shunt patency, and survival in patients with benign portal vein thrombosis undergoing endovascular treatment. Read More

J Vasc Interv Radiol 2018 12 2;29(12):1713-1716. Epub 2018 Nov 2.

Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Electronic address:

Three patients with a medical history of breast carcinoma and metastatic carcinomatous liver disease associated with severe portal hypertension and refractory ascites are presented. Transjugular intrahepatic portosystemic shunt creation was considered as a palliative treatment option and a valuable alternative to regular paracenteses in these patients. In 2 of the 3 patients, the refractory ascites was controlled for several months without need for paracentesis, and subsequently transjugular intrahepatic portosystemic shunt may provide valuable palliation and ascites control in patients with refractory ascites due to breast cancer-induced pseudocirrhosis. Read More

Gastrointest Endosc 2019 02 31;89(2):238-246.e3. Epub 2018 Oct 31.

Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Background And Aims: EUS-guided liver biopsy (LB) is an emerging technique over conventional percutaneous (PC) or transjugular (TJ) approaches. Recent studies have reported that EUS-guided LB may have a better safety profile than PC LB or TJ LB without compromising diagnostic yield, and the outcomes are varied with respect to the types of biopsy needles. We performed a systematic review and meta-analysis to estimate the diagnostic yield, specimen adequacy, and adverse events associated with EUS-guided LB. Read More

Exp Clin Transplant 2019 04 24;17(2):214-221. Epub 2018 Oct 24.

From the Department of General Surgery, Liver Transplant Center, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.

Objectives: Veno-occlusive disease after liver transplant has been sporadically reported, and significant uncertainty exists concerning the best treatment and the long-term outcomes. Here, we reviewed our experience to evaluate clinical presentation, treatment, and the long-term outcomes of these patients.

Materials And Methods: Between 2000 and 2015, 2165 patients underwent liver transplant at our center. Read More