title: Laparoscopic division of a portosystemic shunt to treat chronic hepatic encephalopathy.
abstract: In the event of liver cirrhosis with severe portal hypertension, voluminous portosystemic shunt may lead to refractory encephalopathy. Obliteration of the shunt has been described as a satisfactory therapeutic solution, and reported procedures are mainly endovascular embolization and surgical shunt ligation through laparotomy. The former procedure is less invasive and seems to be as efficient. Laparoscopy, which is widely recognized to minimize mortality and morbidity in cirrhotic patients undergoing surgery, has never been used for such a procedure. Shunt division can therefore be considered using this modern approach to good effect and reduced morbidity. In support of this view, we report a case of severe chronic encephalopathy cured by laparoscopic surgical division of a large shunt after failure of the percutaneous technique.
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Seman
authors.forename: Olivier
authors.initials: O
authors.lastname: Scatton
authors.forename: Stephane
authors.initials: S
authors.lastname: Zalinski
authors.forename: Ariane
authors.initials: A
authors.lastname: Chrissostalis
authors.forename: Paul
authors.initials: P
authors.lastname: Legmann
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
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