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PubMed · 6970990

Bleeding esophageal varices.

F L Sax·A M Cooperman
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Abstract

The unresolved issue of the optimal treatment of portal hypertension attests to the disappointments in present treatment. In reality, the disappointments are a result of progressive liver disease, which is not helped and probably deteriorates more rapidly after shunting operations. This dissatisfaction has led some to abandon shunts and to accept a higher incidence or potential for recurrent bleeding after nonshunting operations. The long-term results of splenic artery ligation and perhaps embolization are awaited with interest. Until then, as Conn has said, "We must learn to select better who should be shunted or to shunt better those we select".

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Embolization, TherapeuticEsophageal and Gastric VaricesGastrointestinal HemorrhageHumansHypertension, PortalLiver CirculationLiver DiseasesPortal SystemPortasystemic Shunt, SurgicalRadiographySplenic ArteryJournal Article

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BibTeXRIS

F L Sax, A M Cooperman. 1981. Bleeding esophageal varices.. https://doi.org/10.1016/s0039-6109(16)42344-3

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Mechanisms of hepatic regeneration following portal vein embolization and partial hepatectomy: a review.

BACKGROUND: Portal vein embolization (PVE) improves outcome following major hepatectomy, and basic studies have presented evidence related to the mechanisms responsible for hepatic regeneration. Hemodynamic changes following PVE are similar to, but slightly different from, those of partial hepatectomy (PH) because arterial flow to the embolized lobe is preserved. However, the process of hepatic regeneration is essentially the same after both PVE and PH. A number of mediators are involved in PVE or PH-induced hepatic regeneration. These include inflammatory cytokines, vasoregulators, growth factors, eicosanoids, and various hormones. These mediators activate a complex network of signal transduction that promotes hepatic regeneration. A variety of conditions have been shown to modulate the function of these mediators and inhibit regeneration. These include biliary obstruction, diabetes, chronic ethanol consumption, malnutrition, gender, aging, and infection. CONCLUSION: Optimizing these factors, where possible, before PVE or PH, is essential to maximize hypertrophy of the liver. A fuller understanding of hepatic physiology and pathophysiology following PVE or PH may lead to greater functional capacity of the remaining liver and extend the indications for hepatectomy in patients who require large liver volume resection.

Embolization, Therapeutic↗