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Impact of spontaneous splenorenal shunt on liver volume and long‐term survival of liver cirrhosis
Background and Aim Spontaneous splenorenal shunt (SSRS) is one of the manifestations of portal hypertension in liver cirrhosis. However, the impact of SSRS on long‐term survival of cirrhotic patients remains unclear. We hypothesize that SSRS may worsen liver dysfunction and deteriorate prognosis in...
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| Published in: | Journal of gastroenterology and hepatology 2021-06, Vol.36 (6), p.1694-1702 |
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| container_title | Journal of gastroenterology and hepatology |
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| creator | Yi, Fangfang Guo, Xiaozhong Wang, Le Xu, Xiangbo An, Yang Tang, Yufu Zhang, Wenwen Tacke, Frank Arora, Ankur Qi, Xingshun |
| description | Background and Aim
Spontaneous splenorenal shunt (SSRS) is one of the manifestations of portal hypertension in liver cirrhosis. However, the impact of SSRS on long‐term survival of cirrhotic patients remains unclear. We hypothesize that SSRS may worsen liver dysfunction and deteriorate prognosis in liver cirrhosis by decreasing hepatic perfusion.
Methods
Patients with liver cirrhosis who were admitted to our department between December 2014 and August 2019 and underwent contrast‐enhanced computed tomography or magnetic resonance imaging scans were prospectively collected. The maximum diameters of SSRS and portal vein system vessels were retrospectively measured. Liver‐to‐abdominal area ratio, Child–Pugh, and model for end‐stage liver disease scores were calculated.
Results
Overall, 122 cirrhotic patients were included. The prevalence of SSRS was 30.3% (37/122). Median diameter of SSRS was 13.5 mm. Patients with SSRS had significantly thinner diameters of right portal vein (9 mm vs 11.2 mm, P = 0.001) and main portal vein (15.3 mm vs 16.8 mm, P = 0.017) than those without SSRS. Patients with SSRS had significantly lower liver‐to‐abdominal area ratio score (25.39 vs 31.58, P |
| doi_str_mv | 10.1111/jgh.15386 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2475090166</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2539053238</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4196-c37ca1e0794e2a5be00774fa557b0b178e2ab77a9c252e23396b302f67f491823</originalsourceid><addsrcrecordid>eNp10EFLwzAUB_AgipvTg19ACl700O2lSZr2KEO3ieBFzyXN0q0jbWqyVnbzI_gZ_SRGOz0I5vLC48cf3h-hcwxj7N9ks1qPMSNJfICGmFIIMafxIRpCglmYEpwO0IlzGwCgwNkxGhBC_BriIZKLqhFyG5gicI2pt6JWpnX-r1VtrKqFDty6rT2oA112ygad0W2lAlEvA23q1cfb-1bZKnCt7crOc5_UQ1lauzaudKfoqBDaqbP9HKHnu9un6Tx8eJwtpjcPoaQ4jUNJuBRYAU-pigTLFQDntBCM8RxyzBO_zTkXqYxYpCJ_QpwTiIqYFzTFSURG6KrPbax5aZXbZlXppNK6PyqLKGeQAo5jTy__0I1prb_WK0ZSYCQiiVfXvZLWOGdVkTW2rITdZRiyr-Yz33z23by3F_vENq_U8lf-VO3BpAevpVa7_5Oy-9m8j_wEiJeNzw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2539053238</pqid></control><display><type>article</type><title>Impact of spontaneous splenorenal shunt on liver volume and long‐term survival of liver cirrhosis</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Yi, Fangfang ; Guo, Xiaozhong ; Wang, Le ; Xu, Xiangbo ; An, Yang ; Tang, Yufu ; Zhang, Wenwen ; Tacke, Frank ; Arora, Ankur ; Qi, Xingshun</creator><creatorcontrib>Yi, Fangfang ; Guo, Xiaozhong ; Wang, Le ; Xu, Xiangbo ; An, Yang ; Tang, Yufu ; Zhang, Wenwen ; Tacke, Frank ; Arora, Ankur ; Qi, Xingshun</creatorcontrib><description>Background and Aim
Spontaneous splenorenal shunt (SSRS) is one of the manifestations of portal hypertension in liver cirrhosis. However, the impact of SSRS on long‐term survival of cirrhotic patients remains unclear. We hypothesize that SSRS may worsen liver dysfunction and deteriorate prognosis in liver cirrhosis by decreasing hepatic perfusion.
Methods
Patients with liver cirrhosis who were admitted to our department between December 2014 and August 2019 and underwent contrast‐enhanced computed tomography or magnetic resonance imaging scans were prospectively collected. The maximum diameters of SSRS and portal vein system vessels were retrospectively measured. Liver‐to‐abdominal area ratio, Child–Pugh, and model for end‐stage liver disease scores were calculated.
Results
Overall, 122 cirrhotic patients were included. The prevalence of SSRS was 30.3% (37/122). Median diameter of SSRS was 13.5 mm. Patients with SSRS had significantly thinner diameters of right portal vein (9 mm vs 11.2 mm, P = 0.001) and main portal vein (15.3 mm vs 16.8 mm, P = 0.017) than those without SSRS. Patients with SSRS had significantly lower liver‐to‐abdominal area ratio score (25.39 vs 31.58, P < 0.001) and higher Child–Pugh (7 vs 6, P = 0.046) and model for end‐stage liver disease (12.17 vs 9.79, P < 0.006) scores than those without SSRS. Patients with SSRS had a significantly lower cumulative survival rate than those without SSRS (P = 0.014). Cox regression analysis also showed that SSRS was a risk factor of death of cirrhotic patients (hazard ratio = 4.161, 95% confidence interval = 1.215–14.255, P = 0.023).
Conclusions
Spontaneous splenorenal shunt may narrow portal vein diameter and shrink liver volume, thereby worsening liver function and increasing mortality in liver cirrhosis.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.15386</identifier><identifier>PMID: 33393106</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Cirrhosis ; Computed tomography ; LAAR ; Liver cirrhosis ; Liver diseases ; liver function ; Magnetic resonance imaging ; Medical prognosis ; mortality ; Perfusion ; Portal vein ; Risk factors ; spontaneous splenorenal shunt ; Survival ; Veins & arteries</subject><ispartof>Journal of gastroenterology and hepatology, 2021-06, Vol.36 (6), p.1694-1702</ispartof><rights>2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><rights>2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4196-c37ca1e0794e2a5be00774fa557b0b178e2ab77a9c252e23396b302f67f491823</citedby><cites>FETCH-LOGICAL-c4196-c37ca1e0794e2a5be00774fa557b0b178e2ab77a9c252e23396b302f67f491823</cites><orcidid>0000-0001-6206-0226 ; 0000-0002-6720-7124 ; 0000-0002-0172-3687 ; 0000-0002-9448-6739 ; 0000-0003-0233-6272 ; 0000-0002-6397-0501 ; 0000-0003-0021-823X ; 0000-0002-1475-0334 ; 0000-0002-8561-6810 ; 0000-0002-1882-5903</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33393106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yi, Fangfang</creatorcontrib><creatorcontrib>Guo, Xiaozhong</creatorcontrib><creatorcontrib>Wang, Le</creatorcontrib><creatorcontrib>Xu, Xiangbo</creatorcontrib><creatorcontrib>An, Yang</creatorcontrib><creatorcontrib>Tang, Yufu</creatorcontrib><creatorcontrib>Zhang, Wenwen</creatorcontrib><creatorcontrib>Tacke, Frank</creatorcontrib><creatorcontrib>Arora, Ankur</creatorcontrib><creatorcontrib>Qi, Xingshun</creatorcontrib><title>Impact of spontaneous splenorenal shunt on liver volume and long‐term survival of liver cirrhosis</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
Spontaneous splenorenal shunt (SSRS) is one of the manifestations of portal hypertension in liver cirrhosis. However, the impact of SSRS on long‐term survival of cirrhotic patients remains unclear. We hypothesize that SSRS may worsen liver dysfunction and deteriorate prognosis in liver cirrhosis by decreasing hepatic perfusion.
Methods
Patients with liver cirrhosis who were admitted to our department between December 2014 and August 2019 and underwent contrast‐enhanced computed tomography or magnetic resonance imaging scans were prospectively collected. The maximum diameters of SSRS and portal vein system vessels were retrospectively measured. Liver‐to‐abdominal area ratio, Child–Pugh, and model for end‐stage liver disease scores were calculated.
Results
Overall, 122 cirrhotic patients were included. The prevalence of SSRS was 30.3% (37/122). Median diameter of SSRS was 13.5 mm. Patients with SSRS had significantly thinner diameters of right portal vein (9 mm vs 11.2 mm, P = 0.001) and main portal vein (15.3 mm vs 16.8 mm, P = 0.017) than those without SSRS. Patients with SSRS had significantly lower liver‐to‐abdominal area ratio score (25.39 vs 31.58, P < 0.001) and higher Child–Pugh (7 vs 6, P = 0.046) and model for end‐stage liver disease (12.17 vs 9.79, P < 0.006) scores than those without SSRS. Patients with SSRS had a significantly lower cumulative survival rate than those without SSRS (P = 0.014). Cox regression analysis also showed that SSRS was a risk factor of death of cirrhotic patients (hazard ratio = 4.161, 95% confidence interval = 1.215–14.255, P = 0.023).
Conclusions
Spontaneous splenorenal shunt may narrow portal vein diameter and shrink liver volume, thereby worsening liver function and increasing mortality in liver cirrhosis.</description><subject>Cirrhosis</subject><subject>Computed tomography</subject><subject>LAAR</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>liver function</subject><subject>Magnetic resonance imaging</subject><subject>Medical prognosis</subject><subject>mortality</subject><subject>Perfusion</subject><subject>Portal vein</subject><subject>Risk factors</subject><subject>spontaneous splenorenal shunt</subject><subject>Survival</subject><subject>Veins & arteries</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10EFLwzAUB_AgipvTg19ACl700O2lSZr2KEO3ieBFzyXN0q0jbWqyVnbzI_gZ_SRGOz0I5vLC48cf3h-hcwxj7N9ks1qPMSNJfICGmFIIMafxIRpCglmYEpwO0IlzGwCgwNkxGhBC_BriIZKLqhFyG5gicI2pt6JWpnX-r1VtrKqFDty6rT2oA112ygad0W2lAlEvA23q1cfb-1bZKnCt7crOc5_UQ1lauzaudKfoqBDaqbP9HKHnu9un6Tx8eJwtpjcPoaQ4jUNJuBRYAU-pigTLFQDntBCM8RxyzBO_zTkXqYxYpCJ_QpwTiIqYFzTFSURG6KrPbax5aZXbZlXppNK6PyqLKGeQAo5jTy__0I1prb_WK0ZSYCQiiVfXvZLWOGdVkTW2rITdZRiyr-Yz33z23by3F_vENq_U8lf-VO3BpAevpVa7_5Oy-9m8j_wEiJeNzw</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Yi, Fangfang</creator><creator>Guo, Xiaozhong</creator><creator>Wang, Le</creator><creator>Xu, Xiangbo</creator><creator>An, Yang</creator><creator>Tang, Yufu</creator><creator>Zhang, Wenwen</creator><creator>Tacke, Frank</creator><creator>Arora, Ankur</creator><creator>Qi, Xingshun</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6206-0226</orcidid><orcidid>https://orcid.org/0000-0002-6720-7124</orcidid><orcidid>https://orcid.org/0000-0002-0172-3687</orcidid><orcidid>https://orcid.org/0000-0002-9448-6739</orcidid><orcidid>https://orcid.org/0000-0003-0233-6272</orcidid><orcidid>https://orcid.org/0000-0002-6397-0501</orcidid><orcidid>https://orcid.org/0000-0003-0021-823X</orcidid><orcidid>https://orcid.org/0000-0002-1475-0334</orcidid><orcidid>https://orcid.org/0000-0002-8561-6810</orcidid><orcidid>https://orcid.org/0000-0002-1882-5903</orcidid></search><sort><creationdate>202106</creationdate><title>Impact of spontaneous splenorenal shunt on liver volume and long‐term survival of liver cirrhosis</title><author>Yi, Fangfang ; Guo, Xiaozhong ; Wang, Le ; Xu, Xiangbo ; An, Yang ; Tang, Yufu ; Zhang, Wenwen ; Tacke, Frank ; Arora, Ankur ; Qi, Xingshun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4196-c37ca1e0794e2a5be00774fa557b0b178e2ab77a9c252e23396b302f67f491823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cirrhosis</topic><topic>Computed tomography</topic><topic>LAAR</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>liver function</topic><topic>Magnetic resonance imaging</topic><topic>Medical prognosis</topic><topic>mortality</topic><topic>Perfusion</topic><topic>Portal vein</topic><topic>Risk factors</topic><topic>spontaneous splenorenal shunt</topic><topic>Survival</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yi, Fangfang</creatorcontrib><creatorcontrib>Guo, Xiaozhong</creatorcontrib><creatorcontrib>Wang, Le</creatorcontrib><creatorcontrib>Xu, Xiangbo</creatorcontrib><creatorcontrib>An, Yang</creatorcontrib><creatorcontrib>Tang, Yufu</creatorcontrib><creatorcontrib>Zhang, Wenwen</creatorcontrib><creatorcontrib>Tacke, Frank</creatorcontrib><creatorcontrib>Arora, Ankur</creatorcontrib><creatorcontrib>Qi, Xingshun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yi, Fangfang</au><au>Guo, Xiaozhong</au><au>Wang, Le</au><au>Xu, Xiangbo</au><au>An, Yang</au><au>Tang, Yufu</au><au>Zhang, Wenwen</au><au>Tacke, Frank</au><au>Arora, Ankur</au><au>Qi, Xingshun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of spontaneous splenorenal shunt on liver volume and long‐term survival of liver cirrhosis</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2021-06</date><risdate>2021</risdate><volume>36</volume><issue>6</issue><spage>1694</spage><epage>1702</epage><pages>1694-1702</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
Spontaneous splenorenal shunt (SSRS) is one of the manifestations of portal hypertension in liver cirrhosis. However, the impact of SSRS on long‐term survival of cirrhotic patients remains unclear. We hypothesize that SSRS may worsen liver dysfunction and deteriorate prognosis in liver cirrhosis by decreasing hepatic perfusion.
Methods
Patients with liver cirrhosis who were admitted to our department between December 2014 and August 2019 and underwent contrast‐enhanced computed tomography or magnetic resonance imaging scans were prospectively collected. The maximum diameters of SSRS and portal vein system vessels were retrospectively measured. Liver‐to‐abdominal area ratio, Child–Pugh, and model for end‐stage liver disease scores were calculated.
Results
Overall, 122 cirrhotic patients were included. The prevalence of SSRS was 30.3% (37/122). Median diameter of SSRS was 13.5 mm. Patients with SSRS had significantly thinner diameters of right portal vein (9 mm vs 11.2 mm, P = 0.001) and main portal vein (15.3 mm vs 16.8 mm, P = 0.017) than those without SSRS. Patients with SSRS had significantly lower liver‐to‐abdominal area ratio score (25.39 vs 31.58, P < 0.001) and higher Child–Pugh (7 vs 6, P = 0.046) and model for end‐stage liver disease (12.17 vs 9.79, P < 0.006) scores than those without SSRS. Patients with SSRS had a significantly lower cumulative survival rate than those without SSRS (P = 0.014). Cox regression analysis also showed that SSRS was a risk factor of death of cirrhotic patients (hazard ratio = 4.161, 95% confidence interval = 1.215–14.255, P = 0.023).
Conclusions
Spontaneous splenorenal shunt may narrow portal vein diameter and shrink liver volume, thereby worsening liver function and increasing mortality in liver cirrhosis.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33393106</pmid><doi>10.1111/jgh.15386</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6206-0226</orcidid><orcidid>https://orcid.org/0000-0002-6720-7124</orcidid><orcidid>https://orcid.org/0000-0002-0172-3687</orcidid><orcidid>https://orcid.org/0000-0002-9448-6739</orcidid><orcidid>https://orcid.org/0000-0003-0233-6272</orcidid><orcidid>https://orcid.org/0000-0002-6397-0501</orcidid><orcidid>https://orcid.org/0000-0003-0021-823X</orcidid><orcidid>https://orcid.org/0000-0002-1475-0334</orcidid><orcidid>https://orcid.org/0000-0002-8561-6810</orcidid><orcidid>https://orcid.org/0000-0002-1882-5903</orcidid></addata></record> |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Cirrhosis Computed tomography LAAR Liver cirrhosis Liver diseases liver function Magnetic resonance imaging Medical prognosis mortality Perfusion Portal vein Risk factors spontaneous splenorenal shunt Survival Veins & arteries |
| title | Impact of spontaneous splenorenal shunt on liver volume and long‐term survival of liver cirrhosis |
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