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Noninvasive Assessment of portal Hypertension in Patients With Primary Biliary Cholangitis is Affected by Severity of Cholestasis.
Clin Gastroenterol Hepatol
December 2024
Division of Gastroenterology, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. Electronic address:
Background & Aims: Noninvasive tests (NITs) for ruling-out clinical significant portal hypertension (CSPH) and high-risk varices (HRVs) in patients with primary biliary cholangitis (PBC) and compensated advanced chronic liver disease (cACLD) are lacking. We evaluated NITs in these patients and the influence of cholestasis on their performance.
Methods: Consecutive patients from the "Italian PBC registry" and 2 United Kingdom large-volume PBC referral centers with upper endoscopy within 6 months from biochemical evaluation and transient elastography were included.
Prediction Modelling for Gastroesophageal Variceal Bleeding in Patients With Chronic Hepatitis B Using Four-dimensional Flow MRI.
J Clin Exp Hepatol
August 2024
Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
Article Synopsis
- The study aims to create a predictive model for bleeding from gastroesophageal varices (GEV) in chronic hepatitis B (CHB) patients using hemodynamic data from 4D flow MRI.
- Researchers enrolled 40 CHB patients and used clinical assessments and imaging techniques to categorize them into high-risk and non-high-risk groups for GEV bleeding.
- The developed model, which incorporates factors like spleen diameter and regurgitant fraction, demonstrated high diagnostic efficiency, allowing 45% of patients to skip unnecessary endoscopic procedures while maintaining a low misclassification rate.
Performance of Baveno VII criteria for the screening of varices needing treatment in patients with biliary atresia.
J Pediatr Gastroenterol Nutr
August 2024
Departments of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Objective: Biliary atresia (BA) is the leading cause of liver cirrhosis and chronic liver insufficiency in children in the world. Gastroesophageal varices bleeding is an ominous complication of cirrhosis in BA patients and is associated with high morbidity and mortality. In this study, we aimed to investigate the utility of noninvasive Baveno VI and Baveno VII criteria for the screening of varices need treatment (VNT) and the need for liver transplantation in BA patients.
View Article and Find Full Text PDFNon-Invasive Diagnostic Tests for Portal Hypertension in Patients with HBV- and HCV-Related Cirrhosis: A Comprehensive Review.
Medicina (Kaunas)
April 2024
Gastroenterology and Hepatology Unit, Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, University of Palermo, 90127 Palermo, Italy.
Clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease indicates an increased risk of decompensation and death. While invasive methods like hepatic venous-portal gradient measurement is considered the gold standard, non-invasive tests (NITs) have emerged as valuable tools for diagnosing and monitoring CSPH. This review comprehensively explores non-invasive diagnostic modalities for portal hypertension, focusing on NITs in the setting of hepatitis B and hepatitis C virus-related cirrhosis.
View Article and Find Full Text PDFEvolution of spontaneous portosystemic shunts over time and following aetiological intervention in patients with cirrhosis.
JHEP Rep
February 2024
Liver Unit, Digestive Diseases Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research (VHIR), Vall d'Hebron Barcelona Hospital Campus. Universitat Autònoma de Barcelona, Barcelona, Spain.
Article Synopsis
- Spontaneous portosystemic shunts (SPSS) often develop in patients with cirrhosis, and their progression over time, especially in relation to treatments like alcohol abstinence or antiviral therapy for HCV, was the focus of this study.
- In a cohort of 617 patients followed over an average of 63 months, there was a noticeable increase in the severity of SPSS, with larger and more frequent shunts observed, particularly among non-cured patients who experienced poorer liver function and more complications.
- Overall, while interventions like quitting alcohol or successful HCV treatment improved liver health and reduced complications, SPSS continued to exist and worsen, albeit at a slower rate in patients who were cured.
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