{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:06:20Z","timestamp":1761843980017},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2010,2,17]],"date-time":"2010-02-17T00:00:00Z","timestamp":1266364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The purpose of the present study was to investigate the short\u2010term effects of combined therapy using partial splenic embolization (PSE) and transjugular retrograde obliteration (TJO) on the portal hemodynamics of gastric varices with a gastrorenal shunt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Sixteen patients with gastric varices and a gastrorenal shunt were included in this study. Partial splenic embolization was applied 2 weeks before TJO. The portal blood flow was measured by an ultrasonic duplex Doppler system, and the wedged hepatic venous pressure (WHVP) was measured by hepatic venous catheterization, before and after the combined therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The complete obliteration of the gastrorenal shunt and gastric varices was revealed by retrograde shuntography and computed tomography after TJO in all cases. The WHVP before and just after PSE was 23 \u00b1 7 and 19 \u00b1 7\u00a0mmHg, respectively, showing a significant change (<jats:italic>P<\/jats:italic> &lt; 0.01). The WHVP before and the day after TJO was 20 \u00b1 5\u00a0mmHg and 22 \u00b1 6\u00a0mmHg, respectively, showing a significant change (<jats:italic>P<\/jats:italic> &lt; 0.01). There was no significant difference between the WHVP before and after the combined therapy. The portal venous flow volume before and after the combined therapy were 514 \u00b1 146 and 512 \u00b1 161\u00a0ml\/min, respectively, showing no significant change. However, the splenic venous flow volume before and after the combined therapy was 319 \u00b1 131 and 179 \u00b1 113\u00a0ml\/min, respectively, showing a significant change (<jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The WHVP did not change after the combined therapy of PSE and TJO. Partial splenic embolization contributed to protecting portal congestion after TJO. We conclude that the combined therapy using PSE and TJO is an effective treatment for gastric varices from the portal hemodynamic point of view.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0451-2","type":"journal-article","created":{"date-parts":[[2010,2,16]],"date-time":"2010-02-16T20:43:02Z","timestamp":1266352982000},"page":"1046-1051","source":"Crossref","is-referenced-by-count":16,"title":["Hemodynamic Effects of Combined Therapy Using Partial Splenic Embolization and Transjugular Retrograde Obliteration for Gastric Varices with Gastrorenal Shunt"],"prefix":"10.1002","volume":"34","author":[{"given":"Fumio","family":"Chikamori","sequence":"first","affiliation":[{"name":"Department of Surgery Kuniyoshi Hospital 1\u20103\u20104 Kamimachi 780\u20100901 Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Surgery Kuniyoshi Hospital 1\u20103\u20104 Kamimachi 780\u20100901 Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kuniyoshi Hospital 1\u20103\u20104 Kamimachi 780\u20100901 Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobutoshi","family":"Kuniyoshi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kuniyoshi Hospital 1\u20103\u20104 Kamimachi 780\u20100901 Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiko","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Department of Surgery Tsukuba Soai Hospital 1008 Takasaki 300\u20101245 Kukisaki Ibaraki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Takase","sequence":"additional","affiliation":[{"name":"Department of Surgery Tsukuba Soai Hospital 1008 Takasaki 300\u20101245 Kukisaki Ibaraki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,2,17]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002619900068"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101746.1996.tb00010.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(01)21563-3"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.3356"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105107(90)71023\u20101"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000018874"},{"key":"e_1_2_6_8_2","first-page":"1847","article-title":"Short\u2010term portal hemodynamic effects of partial splenic embolization for hypersplenism","volume":"54","author":"Chikamori F","year":"2007","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000050126"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(88)90501-X"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.183.2.1830369"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100314\u2010x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004424\u2010197911000\u201000003"},{"key":"e_1_2_6_14_2","first-page":"947","article-title":"Bleeding portal\u2010hypertensive gastropathy managed successfully by partial splenic embolization","volume":"49","author":"Shimizu T","year":"2002","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_15_2","first-page":"1445","article-title":"Long\u2010term hematological and biochemical effects of partial splenic embolization in hepatic cirrhosis","volume":"49","author":"Tajiri T","year":"2002","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_16_2","first-page":"1552","article-title":"A comparison of combination endoscopic therapy and interventional radiology with esophageal transection for the treatment of esophageal varices","volume":"49","author":"Tajiri T","year":"2002","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-002-0342-6"},{"key":"e_1_2_6_18_2","first-page":"1212","article-title":"Long term follow\u2010up for patients with liver cirrhosis after partial splenic embolization","volume":"43","author":"Murata K","year":"1996","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_19_2","first-page":"169","article-title":"Gastroesophageal decongestion and splenectomy in the treatment of esophageal varices in bilharzial cirrhosis; 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