ASGE DDW Videos from Around the World | 2024-ENDOSCOPIC ULTRASOUND GUIDED PORTO-SPLENIC SPLIT(EPSS) FOR REFRACTORY HEPATIC ENCEPHALOPATHY:NEW FRONTIERS FOR ENDOHEPATOLOGY

ENDOSCOPIC ULTRASOUND GUIDED PORTO-SPLENIC SPLIT(EPSS) FOR REFRACTORY HEPATIC ENCEPHALOPATHY:NEW FRONTIERS FOR ENDOHEPATOLOGY

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Video Summary

Patients with refractory hepatic encephalopathy, a complication of liver cirrhosis, face limited treatment options such as transplant or shunt occlusion. One 45-year-old male with ethanol-related cirrhosis and recurrent symptoms opted for an experimental procedure involving splenic vein occlusion to redirect splenic outflow away from the liver. Using coils and glue injected via endoscopic ultrasound, the shunt was successfully obliterated, resulting in significant clinical improvement. The patient experienced reduced symptoms of hepatic encephalopathy, improved speech, and overall better quality of life post-procedure. While still requiring further study, this novel approach shows promise for patients with unresponsive conditions.

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Video Plenary
Sahaj Rathi

Keywords

hepatic encephalopathy

liver cirrhosis

transplant

shunt occlusion

splenic vein occlusion