{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:22:29Z","timestamp":1782602549740,"version":"3.54.5"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2010,5,26]],"date-time":"2010-05-26T00:00:00Z","timestamp":1274832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background and Aims:\u2002<\/jats:bold> It is well known that a large portosystemic shunt develops during portal hypertension. In this study, we studied the long\u2010term effects of a large splenorenal shunt (SRS) on liver function and survival.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> The subjects were divided into three groups: an SRS (\u2212) group consisting of cirrhotic patients without SRS; an SRS (+) group consisting of patients with gastric fundal varices and SRS; and a balloon\u2010occluded retrograde transvenous obliteration (B\u2010RTO) group with a completely obliterated SRS by B\u2010RTO. We compared the following among these groups: the total bilirubin levels, serum albumin levels, prothrombin times, changes in Child\u2013Pugh scores, and survival rates.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> After a 3\u2010year follow\u2010up period the Child\u2013Pugh scores showed significant differences among the SRS (+), SRS (\u2212), and B\u2010RTO groups. The score worsened for the SRS (+) group. The cumulative survival rates were significantly different between the SRS (+) and SRS (\u2212) groups and between the SRS (+) and B\u2010RTO groups. The vital prognosis worsened for the SRS (+) group.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> The presence of a large splenorenal shunt (portosystemic shunt) was indicated to lower liver function and vital prognosis. B\u2010RTO, which completely obliterates large splenorenal shunts, inhibited the lowering of hepatic functional reserve and the worsening of vital prognosis, indicating a protective role. Liver pathology and the presence of a large portosystemic shunt each separately result in progressive liver dysfunction and worsen the survival rate. We found that such a pathological condition had occurred due to a large portosystemic shunt, and it should be called \u2018portosystemic shunt syndrome.\u2019<\/jats:p>","DOI":"10.1111\/j.1440-1746.2010.06262.x","type":"journal-article","created":{"date-parts":[[2010,1,14]],"date-time":"2010-01-14T12:12:05Z","timestamp":1263471125000},"page":"1129-1135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":120,"title":["Long\u2010term results of balloon\u2010occluded retrograde transvenous obliteration for gastric fundal varices: Hepatic deterioration links to portosystemic shunt syndrome"],"prefix":"10.1111","volume":"25","author":[{"given":"Masafumi","family":"Kumamoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Toyonaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Miyakoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiko","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keigo","family":"Emori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Oho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Sata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,5,26]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(88)90501-X"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1996.tb00010.x"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.167.5.8911204"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.211.2.r99ma25349"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.178.5.1781167"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2003.4.2.109"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-005-1654-4"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.184.4.01841340"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002709900118"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61912-5"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.40.688"},{"key":"e_1_2_5_13_2","first-page":"1026","article-title":"Changes in liver function parameters after occlusion of gastrorenal shunts with balloon\u2010occluded retrograde transvenous obliteration","volume":"92","author":"Akahane T","year":"1997","journal-title":"Am. 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