scholarly journals Alternative Diagnostic Tests of Gastroesophageal Varices in Liver Cirrhosis: Recent Advance

2017 ◽  
Author(s):  
Xingshun Qi ◽  
Qiang Zhu ◽  
Ye Tian
Keyword(s):  
Liver Cirrhosis ◽  
Diagnostic Tests ◽  
Gastroesophageal Varices

scholarly journals Liver Retraction Using n-Butyl-2-Cyanoacrylate (NBCA) Glue during Laparoscopic Splenectomy and Azygoportal Disconnection in Cirrhotic Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Du Kong ◽  
Wei Wang ◽  
Gang Du ◽  
Binyao Shi ◽  
Zhengchen Jiang ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Function ◽  
Blood Loss ◽  
Laparoscopic Splenectomy ◽  
Postoperative Bleeding ◽  
Gastroesophageal Varices ◽  
Liver Retraction ◽  
Significant Difference ◽  
Cirrhotic Patients

Background. Although liver retraction using n-butyl-2-cyanoacrylate (NBCA) glue has been applied to laparoscopic upper abdominal surgery in noncirrhotic patients, there is still no consensus on its safety and feasibility for cirrhotic patients. In this study, we aimed to investigate the safety and effectiveness of liver retraction using NBCA glue during laparoscopic splenectomy and azygoportal disconnection (LSD) for gastroesophageal varices and hypersplenism secondary to liver cirrhosis and portal hypertension. Methods. Thirty-nine gastroesophageal varices and hypersplenism secondary to liver cirrhosis and portal hypertension patients were included in our study. We performed LSD in the presence of NBCA glue (n = 22, NBCA group) and absence of NBCA glue (n = 17, n-NBCA group), respectively. The operation time, blood loss, postoperative hospitalization, and liver function were compared between the two groups. Results. There was no mortality during the operation. One patient in non-NBCA group received open surgery due to parenchyma hemorrhage. Postoperative pleural effusion occurred in 2 cases of the NBCA group and 1 of the non-NBCA group. One showed left subphrenic abscess in the non-NBCA group. No postoperative bleeding occurred after 9-30 months of follow-up. The time of operation in NBCA group was significantly shorter than those in n-NBCA group (198.86±17.86 versus 217.81±20.25min, P<0.01). Blood loss in NBCA group was significantly lower than non-NBCA group (159.09±56.98 versus 212.50±88.51 ml, P<0.05). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased on day 1 after LSD and decreased to normal level on day 7 after LSD in both groups. There was no significant difference in postoperative hospitalization and liver function between the two groups. Conclusion. Liver retraction using NBCA glue during LSD for gastroesophageal varices and hypersplenism secondary to liver cirrhosis and portal hypertension is safe, effective, and feasible.

ACTIVATION OF FACTOR VII IS RELATED TO BLEEDING TENDENCY IN LIVER CIRRHOSIS

1987 ◽  
Author(s):  
V De Angelis ◽  
M Zambon ◽  
L Toffolo ◽  
C Donada ◽  
G L Molaro ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Major Bleeding ◽  
Esophageal Varices ◽  
Coagulation Cascade ◽  
Factor Vii ◽  
Bleeding Tendency ◽  
Gastroesophageal Varices ◽  
Liver Impairment ◽  
Cirrhotic Patients ◽  
Bleeding Episodes

Coagulation abnormalities are among the number of potential risk factors toinitiate the bleeding episodes from gastrcr-esophageal varices in liver cirrhosis. The impairment of liver clearance of activated coagulation factors, the release of thromboplastin-like activity from the necrotic liver cells and the hemodynamic changes due to expanded bollaterals may all contribute to activate the coagulation cascade.However, little is known about the mechanisms leading to this activation. Activated Factor VII (FVIIa) is known totrigger both intrinsec and extrinsec coagulation pathway. Therefore, we measured FVIIa in a group of 33 cirrhotic patients in order to see if a difference between bleeders and non-bleeders patients would correlate with Factor VII activation. The patients were divided in two groups according to the presence or the absence of major bleeding from gastroesophageal varices; haemorragic episodes were confirmed by a gastroscopic examination performed during or immediately after bleeding episodes. Factor VII coagulant assay (VII:C - one stage clotting method) and Factor VII coupled amidolytic assay (VII:CHR) were performed and a factor VII activity ratio (VIIa) was calculated as VII:C/VII:CHR. The results (mean ± S.E.) are summarized in this table:No difference in Vila distribution was seen when the patients were divided on the base of liver impairment (according to Child’s criteria) .Our study shows that FVII activation is related to bleeding from esophageal varices but not to the degree of liver impairment and strongly suggests the existence of an hypercoagulable state in liver cirrhosis, probably related to major bleeding from gastroesophageal varices in cirrhotic patients.

scholarly journals Impact of Sustained Virological Response for Gastroesophageal Varices in Hepatitis-C-Virus-Related Liver Cirrhosis

2019 ◽  
Vol 9 (1) ◽  
pp. 95 ◽  
Author(s):  
Yukihisa Yuri ◽  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Virological Response ◽  
P Value ◽  
Gastroesophageal Varices ◽  
Direct Acting Antiviral ◽  
Direct Acting

We aimed to clarify the relationship between sustained virological response (SVR) and gastroesophageal varices (GEVs) progression among hepatitis C virus (HCV)-related liver cirrhosis (LC) patients treated with interferon (IFN)-based therapies (n = 18) and direct-acting antiviral (DAA)-based therapies (n = 37), and LC patients with no SVR (n = 71) who had already developed GEVs. Factors influencing GEVs progression were also examined. During the follow-up period, GEVs progression was observed in 50 patients (39.7%). The 3-year cumulative GEVs progression rates in the DAA-SVR group, the IFN-SVR group, and the non-SVR group were 32.27%, 5.88%, and 33.76%, respectively (overall p value = 0.0108). Multivariate analysis revealed that sex (p = 0.0430), esophageal varices (EVs) F2 or more (p < 0.0001), and DAA-SVR (p = 0.0126, IFN-SVR as a reference) and non-SVR (p = 0.0012, IFN-SVR as a reference) were independent predictors for GEVs progression. The proportion of GEVs progression in patients with no or F1 EVs was significantly lower than that in patients with F2 or F3 EVs (33.9% (38/112) vs. 85.7% (12/14), p = 0.0003). In conclusion, IFN-based therapies can have a favorable impact for preventing GEVs progression in HCV-related LC patients with GEVs. Clinicians should be aware of a point of no return where SVR is no longer capable of avoiding GEVs progression.

scholarly journals Four-dimensional Flow MRI as a Marker for Risk Stratification of Gastroesophageal Varices in Patients with Liver Cirrhosis

Radiology ◽  
2019 ◽  
Vol 290 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Utaroh Motosugi ◽  
Alejandro Roldán-Alzate ◽  
Peter Bannas ◽  
Adnan Said ◽  
Sean Kelly ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Risk Stratification ◽  
Gastroesophageal Varices ◽  
Dimensional Flow ◽  
Flow Mri

Noninvasive predictors for the presence of gastroesophageal varices in patients with liver cirrhosis

2011 ◽  
Vol 1 (2) ◽  
pp. 51-55
Author(s):  
Hesham M. Abu Gabal ◽  
Helmy M. Elshazly ◽  
Nabil A. Omar ◽  
Hossam A. Taha
Keyword(s):  
Liver Cirrhosis ◽  
Gastroesophageal Varices

scholarly journals Evaluation of platelet count/spleen diameter ratio for detection of oesophageal varices in patients with cirrhosis of liver: a cross-sectional study

2021 ◽  
Author(s):  
Ashok Mysore Lakshminarayana ◽  
Shweta Mallikarjun Kumbar ◽  
Manohara Melur Chandregowda ◽  
Kiran Warrier
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Cross Sectional Study ◽  
Current Evidence ◽  
Oesophageal Varices ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gastroesophageal Varices ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Gastroesophageal varices due to portal hypertension in patients with liver cirrhosis is an important cause of morbidity and mortality. Gold standard investigation for varices is esophagogastroduodenoscopy and patients are advised to undergo regular follow up based on the risk stratification. But the invasive nature, risk of procedure-related complication and lack of accessibility and affordability makes it important to identify simpler methods to screen patients. Platelet count/spleen diameter (PSD) ratio has been validated as a marker for oesophageal varices (OV) in multiple studies but with varying results. The present study was conducted to evaluate the accuracy of PSD ratio in OV.Methods: A cross-sectional study was conducted in patients diagnosed with liver cirrhosis. Clinical examination, relevant laboratory investigations, abdominal ultrasound and endoscopy were performed and data were recorded. PSD was calculated. Receiver-operator characteristics curves were plotted to determine cut-off values. Sensitivity, specificity, positive and negative predictive values were calculated.Results: Total 100 patients were included in this study, out of which 25% of patients did not have varices on endoscopy. The mean PSD was for patients without varices 1242.82 (253.45) and 883.51 (582.38467) for patients with OV. The area-under-curve was 0.823, 95% CI=0.734-0.912, p value=0.000001. The cut-off value for PSD was calculated from the ROC analysis was 1077. The sensitivity, specificity, positive and negative predictive values were 76%, 88%, 95% and 55% respectively.Conclusions: PSD ratio is not an efficient parameter for detection of varices in patients with liver cirrhosis. The current evidence does not support its role as a screening test for identification of patients with OV.

scholarly journals Portal and Mesenteric Venous Calcification in Patients with Advanced Cirrhosis: Two Case Reports and Literature

2021 ◽  
Author(s):  
Bing Pan ◽  
Shao-Cheng Lyu ◽  
Qiang He
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Poor Prognosis ◽  
Case Reports ◽  
Vascular Lesions ◽  
Preoperative Imaging ◽  
Gastroesophageal Varices ◽  
Vein Thrombosis ◽  
Advanced Cirrhosis

Abstract The incidence of portal and mesenteric venous calcifications in patients with cirrhosis has rarely been reported. It is also very difficult to determine the vascular lesions in preoperative imaging examination. The liver cirrhosis patients associated with portal venous calcification have high postoperative complications and mortality, but poor prognosis. We present the case of two patients (45-year-old male, case 1; 50-year-old male, case 2). Both patients were admitted to the hospital with liver cirrhosis and portal hypertension associated symptoms. The cases and review of published reports suggest that, calcification in the portal vein system is extremely rare, and always occurs in patients with long-standing liver cirrhosis with portal hypertension gastroesophageal varices and splenomegaly. The presence of portal vein calcification on CT may be a sign of portal vein thrombosis, which may result in a difficult transplantation, and poor prognosis.

Risk factors for 5-day bleeding after endoscopic treatments for gastroesophageal varices in liver cirrhosis

2017 ◽  
pp. 39-39
Author(s):  
Rui Sun ◽  
Xingshun Qi ◽  
Deli Zou ◽  
Xiaodong Shao ◽  
Hongyu Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Gastroesophageal Varices
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