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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2025; 17(10): 110849
Published online Oct 27, 2025. doi: 10.4254/wjh.v17.i10.110849
Published online Oct 27, 2025. doi: 10.4254/wjh.v17.i10.110849
Improved clinical outcomes following embolization of extrahepatic portosystemic shunts in cirrhotic patients with recurrent hepatic encephalopathy
Jong Won Park, Jun Su Lee, Ki Bae Kim, Hee Bok Chae, Department of Internal Medicine, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju 28644, South Korea
Yook Kim, Department of Radiology, Chungbuk National University Hospital, Cheongju 28644, South Korea
Il Soon Jung, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, South Korea
Co-corresponding authors: Yook Kim and Hee Bok Chae.
Author contributions: Park JW collected the clinical and laboratory data; Kim Y performed most interventional procedures; Lee JS, Jung IS, and Kim KB designed the experiments; Chae HB conceived the project and designed the study; Kim Y and Chae HB wrote the manuscript. Kim Y and Chae HB are co-corresponding authors of this manuscript, they were the guarantors of this work and had full access to all the data in the study and took responsibility for the integrity and accuracy of the data analysis.
Institutional review board statement: This work was approved by Chungbuk National University Hospital Institutional Review Board in Cheongju, Chugbuk, South Korea (No. CBNUH2022-09-013-HE001).
Informed consent statement: The requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hee Bok Chae, MD, PhD, Professor, Department of Internal Medicine, Chungbuk National University, College of Medicine and Medical Research Institute, No. 776, 1 Sunhwan-ro, Seowon-gu, Cheongju 28644, South Korea. hbchae@chungbuk.ac.kr
Received: June 17, 2025
Revised: July 11, 2025
Accepted: September 18, 2025
Published online: October 27, 2025
Processing time: 132 Days and 21.5 Hours
Revised: July 11, 2025
Accepted: September 18, 2025
Published online: October 27, 2025
Processing time: 132 Days and 21.5 Hours
Core Tip
Core Tip: Extrahepatic portosystemic shunt (EHPSS) is an underrecognized contributor to hepatic encephalopathy (HE) recurrence and mortality in patients with cirrhosis. In this study, EHPSS embolization significantly improved 1-year survival (50% vs 33%) and prevented HE recurrence (100% vs 17%) compared with no intervention. Embolization also extended both survival and recurrence-free duration. These findings highlight the importance of routine abdominal computed tomo