Ligation and Embolization of Paraumbilical Vein for Portosystemic Encephalopathy -Report of Three Cases-

Yasuhiro Mamada, Masahiko Onda, Takashi Tajiri, D.Y. Kim, Masahito Toba, Mikio Adachi, Matsuomi Umehara, Hiroshi Yoshida, Hideki Nishikubo, Nobuhiko Taniai, Tatsuo Kumazaki*, Tohru Ohya*, Hiroyuki Tajima*, Kazuhito Genma*

First Department of Surgery and Department of Radiology*, Nippon Medical School

The patency of the paraumbilical vein (PUV) may contribute to hepatic encephalopathy as a portosystemic shunt in patients with liver cirrhosis. Accordingly, ligation and embolization of the PVU is thought to affect hepatic encephalopathy. So we have performed ligation of the PUV in 2 patients and embolization in one patient. After the treatments, symptoms of encephalopathy were absent, and the blood ammonia level was improved in all cases. Although portal vein pressure increased, esophago-gastric varices were not affected. In case 3, subsequent splenic artery embolization decreased the portal vein pressure.

Key words
portal hypertension, portosystemic encephalopathy, occlusion of paraumbilical vein

Reprint requests
Yasuhiro Mamada First Department of Surgery, Nippon Medical School
1-1-5 Sendagi Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
October 7, 1992

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