ArticleJournal of hepatocellular carcinoma2026
Surgical Management of Hepatocellular Carcinoma Complicated by Severe Portal Hypertension Secondary to an Arterioportal Shunt: A Case Report.
Article in Journal of hepatocellular carcinoma, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Arterioportal (AP) shunts are a recognized vascular complication of hepatocellular carcinoma (HCC). Severe AP shunts can cause portal hypertension, which can lead to complications such as variceal bleeding and refractory ascites. However, optimal management of HCC complicated by severe AP shunts remains challenging, particularly in patients with advanced disease. Case Presentation: A 73-year-old woman presented with melena and massive hematemesis due to esophageal varices. Contrast-enhanced computed tomography revealed multifocal HCC confined to the right hepatic lobe, Vp3 portal vein tumor thrombosis, and a high-flow AP shunt with hepatofugal portal flow. Despite treatment with diuretics, progressive portal hypertension resulted in rapidly worsening refractory ascites. Although the disease corresponded to Barcelona Clinic Liver Cancer stage C, hepatic functional reserve was relatively preserved, with no extrahepatic metastases having been identified. Angiography revealed a severe AP shunt with persistent opacification of the portal venous system even under balloon-assisted angiography, suggesting exceptionally high shunt flow. Given that the severe portal hypertension was primarily attributed to the AP shunt, right hepatectomy was performed with the dual aim of curative tumor resection and AP shunt elimination. Histopathological examination revealed HCC with portal vein tumor thrombosis and a vessel-encapsulating tumor cluster pattern. Postoperatively, portal venous flow normalized, refractory ascites resolved completely, and tumor marker levels markedly decreased. Conclusion: In carefully selected patients with HCC complicated by a severe AP shunt, hepatectomy may represent a potential treatment option for simultaneously achieving tumor control and alleviating AP shunt-related portal hypertension. Treatment decisions should consider hemodynamic abnormalities in addition to conventional tumor staging and require careful multidisciplinary evaluation.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.