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The modified Sugiura procedure as bridge surgery for liver transplantation: a case report

Overview of attention for article published in Journal of Medical Case Reports, March 2015
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Title
The modified Sugiura procedure as bridge surgery for liver transplantation: a case report
Published in
Journal of Medical Case Reports, March 2015
DOI 10.1186/s13256-015-0522-y
Pubmed ID
Authors

An-Chieh Feng, Chi-Yang Liao, Hsiu-Lung Fan, Teng-Wei Chen, Chung-Bao Hsieh

Abstract

Esophagogastric varices bleeding is a common complication due to portal hypertension in patients with liver cirrhosis. With the advancement of nonoperative management including vasoactive agents, endoscopic hemostasis or transjugular intrahepatic portosystemic shunt, surgical management has played a lesser role in recent decades. The present report describes a patient with hepatitis B (HBV)-related liver cirrhosis and portal vein thrombosis with recurrent esophagogastric varices bleeding despite the use of medical and endoscopic therapy. The modified Sugiura procedure was performed as an alternative bridge surgery for liver transplantation in order not to change the anatomic structure of the great vessels and to avoid hepatic encephalopathy related to shunting procedures like the transjugular intrahepatic portosystemic shunt. A 56-year-old Chinese man with a history of portal hypertension due to HBV-related liver cirrhosis and known former recurrent esophageal varices bleeding status post Sengstaken-Blakemore tube tamponade was referred to our hospital for liver transplantation evaluation because of persistent esophagogastric varices bleeding with hypovolemic shock, even after medical and endoscopic therapies in a local hospital. As a result, liver cirrhosis with Child-Pugh class B function was diagnosed. Despite the use of vasoactive agents, and endoscopic hemostasis management, esophagogastric varices bleeding still occurred episodically with hypovolemic shock, which could not be reversed by blood transfusion or Sengstaken-Blakemore tube tamponade. The modified Sugiura procedure, as an alternative bridge therapy for patients who are candidates for liver transplantation, was performed, despite the fact that his liver transplantation was not yet completed. He then received a living donor liver transplantation with the right lobe of liver from his daughter. The postoperative course was uneventful, and he was discharged two weeks later. He had no evidence of recurrent esophagogastric varices bleeding during the six-month follow-up. The treatment experience of this case gave us not only the idea but also the practical way of applying the modified Sugiura operation as a bridge and rescue therapy without alteration of the vascular anatomy and hemodynamic stability for patients who have experienced refractory esophagogastric varices bleeding, despite the use of medication and endoscopic treatment, and are candidates for receiving a liver transplantation.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 4%
Unknown 22 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 4 17%
Student > Bachelor 3 13%
Professor > Associate Professor 3 13%
Student > Postgraduate 2 9%
Researcher 2 9%
Other 4 17%
Unknown 5 22%
Readers by discipline Count As %
Medicine and Dentistry 16 70%
Biochemistry, Genetics and Molecular Biology 1 4%
Unknown 6 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 January 2016.
All research outputs
#6,064,427
of 7,054,473 outputs
Outputs from Journal of Medical Case Reports
#963
of 1,314 outputs
Outputs of similar age
#262,224
of 318,613 outputs
Outputs of similar age from Journal of Medical Case Reports
#18
of 30 outputs
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So far Altmetric has tracked 1,314 research outputs from this source. They receive a mean Attention Score of 3.0. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 30 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.