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Dig Dis Sci 2019 Apr 15. Epub 2019 Apr 15.

Academic Department of Gastroenterology, Laiko General Hospital, Medical School of National, Kapodistrian University of Athens, 17 Aghiou Thoma, 11527, Athens, Greece.

Background And Aim: To evaluate if spleen stiffness measurement (SSM) can rule out the presence of high-risk varices in patients with cirrhosis, avoiding an upper gastrointestinal endoscopy (UGE).

Methods: We enrolled 71 cirrhotic patients irrespective of liver disease's etiology. 2D shear wave elastography (SWE) of spleen and UGE was performed. Read More

Cells 2019 Apr 4;8(4). Epub 2019 Apr 4.

Gastroenterology Unit, Università di Torino, 10124Torino, Italy.

In clinical trials, a sofosbuvir/velpatasvir (SOF/VEL) pangenotypic single-tablet regimen was associated with high sustained virological response (SVR) rates at 12 weeks (SVR12) after the end of treatment, regardless of genotype and fibrosis stage. No real-life data on genotype 3 (GT3) cirrhotic patients with portal hypertension are available. The aim of this study was to assess the effectiveness of SOF/VEL in GT3 cirrhotics with portal hypertension. Read More

World J Gastroenterol 2019 Apr;25(13):1592-1602

Ludwig Demling Endoscopy Center of Excellence, Division of Gastroenterology, Friedrich-Alexander-University, Erlangen 91054, Germany.

Background: Gastrointestinal (GI) bleeding is a common indication for endoscopy. For refractory cases, hemostatic powders (HP) represent "touch-free" agents.

Aim: To analyze short term (ST-within 72 h-) and long-term (LT-within 30 d-) success for achieving hemostasis with HP and to directly compare the two agents Hemospray (HS) and Endoclot (EC). Read More

World J Hepatol 2019 Mar;11(3):250-260

South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, PL68DH, United Kingdom.

Gastric varices (GV) have different physiology and clinical characteristics compared to oesophageal varices (OV). There is little information about the management of GV. Most part of the recommendations is extrapolated from studies where the majority of participants had OV. Read More

Chirurg 2019 Apr 8. Epub 2019 Apr 8.

Klinik und Poliklinik für Allgemein‑, Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum der Rheinischen Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Deutschland.

Background: Esophageal variceal bleeding is a life-threatening complication in patients with liver cirrhosis, which is pathophysiologically explained by the presence of portal hypertension. The incidence of such bleeding greatly depends on the severity of the underlying liver disease.

Objective: The aim of this article is to present the current treatment concepts for acute esophageal variceal bleeding, the management in acute situations and the indications for treatment of the causal portal hypertension with a transjugular intrahepatic portosystemic shunt (TIPS). Read More

Thromb Res 2019 Apr 1;178:41-46. Epub 2019 Apr 1.

Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, M. Sklodowskiej - Curie 24a, 15-276 Bialystok, Poland.

Aim: We aimed to assess the relationship between procoagulant imbalance and the occurrence of variceal bleeding in patients with liver cirrhosis.

Methods: We compared the results of chromogenic assay for the functional evaluation of the Protein C anticoagulant pathway (ThromboPath®), thromboelastometry and the levels of factor VII, VIII, and antithrombin in two groups of cirrhotic patients: Group 1 (n = 25) - patients with moderate or large esophageal or gastric varices, who had never experienced acute gastrointestinal bleeding and Group 2 (n = 24) - patients with a history of variceal bleeding.

Results: Despite the differences in MELD score and the results of basic laboratory tests indicating more severe cirrhosis and suggesting a greater risk of bleeding in Group 2, the results of thromboelastometry did not differ significantly between groups. Read More

Aliment Pharmacol Ther 2019 Apr 8. Epub 2019 Apr 8.

Department of Clinical Sciences, Lund University, Lund, Sweden.

Background: Liver cirrhosis is characterized by a silent phase until decompensation, which is defined by ascites, bleeding from esophageal varices or hepatic encephalopathy.

Aim: We compare the clinical course, patterns of survival and causes of death by etiology during long-term follow-up in a large population-based cohort of patients with incident cirrhosis.

Material And Methods: We used population-based medical registries for a cohort study of patients with liver cirrhosis diagnosed January 2001 to December 2010, in the Scania region of Sweden. Read More

Mayo Clin Proc 2019 Apr;94(4):714-726

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

Portal hypertension is a major complication of cirrhosis, and its consequences, including ascites, esophageal varices, hepatic encephalopathy, and hepatorenal syndrome, lead to substantial morbidity and mortality. The past several decades have seen major improvements in the clinical management of complications of portal hypertension, resulting in substantial gains in patient outcomes. However, important challenges remain. Read More

Am Surg 2019 Mar;85(3):e179-e181

J Clin Transl Hepatol 2019 Mar 10;7(1):32-39. Epub 2019 Mar 10.

Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

The management of post-endoscopic variceal ligation (EVL) bleeding ulcers (PEBUs) is currently based on local expertise and patients liver disease status. The present retrospective study investigated associations between the endoscopic morphology of PEBUs and patient outcomes. Patients underwent EVL (primary or secondary), from January 2015 to January 2018, in two tertiary care hospitals in India (ILBS New Delhi and Dharamshila Narayana New Delhi). Read More

JAMA Surg 2019 Apr 3. Epub 2019 Apr 3.

Division of Interventional Radiology, Department of Radiology, University of California at Los Angeles Medical Center, David Geffen School of Medicine at University of California, Los Angeles.

Importance: Varices are one of the main clinical manifestations of cirrhosis and portal hypertension. Gastric varices are less common than esophageal varices but are often associated with poorer prognosis, mainly because of their higher propensity to bleed.

Observations: Currently, treatments used to control and manage gastric variceal bleeding include β-blockers, endoscopic injection sclerotherapy, endoscopic variceal ligation, endoscopic variceal obturation, shunt surgery, transjugular intrahepatic portosystemic shunts, balloon-occluded retrograde transvenous obliteration (BRTO), and modified BRTO. Read More

Cureus 2019 Jan 21;11(1):e3933. Epub 2019 Jan 21.

Radiology, The Aga Khan University Hospital, Karachi, PAK.

Objective To determine the diagnostic accuracy of multidetector computed tomography (MDCT) in the detection of esophageal varices by taking endoscopy as the reference standard. Materials and methods This was a cross-sectional prospective study conducted at the Department of Radiology, Aga Khan University Hospital, (AKUH) Karachi, for the duration of 12 months from August 1, 2014 to July 31, 2015. One hundred ninety-six patients with a suspicion of chronic liver disease/cirrhosis undergoing 64 slice MDCT were enrolled in our study and underwent computed tomography (CT) scanning in the Department of Radiology at AKUH. Read More

BJR Case Rep 2018 Dec 10;4(4):20180006. Epub 2018 Jul 10.

Department of Radiology, Good Hope Hospital, Birmingham, UK.

Intussusception of the gastrointestinal viscera is rarely encountered in adult patients and is frequently associated with a polypoidal lead point, which is often malignant. We would like to present the case of a 68-year-old male with a history of decompensated liver disease and multiple medical comorbidities, who was discovered to have an incidental gastrogastric intussusception on CT. No polypoidal lead point was seen and we believe this to be the first case of its kind to be described. Read More

Zhonghua Gan Zang Bing Za Zhi 2019 Mar;27(3):182-191

Transient elastography is a noninvasive, rapid ultrasonic elastography, and assess liver fibrosis by detetcting liver stiffness. Current consensus focuses on understanding influence factors on operation and diagnosis, recommendations for clinical application on detetcting liver fibrosis of chronic liver disease and monitoring development of related complication hepatocelullar carcinoma, high risk esophageal varices, and also summarizes the potential aplication on liver disease screening and liver fibrosis regression assessment. Read More

Dig Liver Dis 2019 Mar 6. Epub 2019 Mar 6.

Paediatric Liver, GI and Transplantation, Hospital Papa Giovanni XXIII Bergamo, Bergamo, Italy. Electronic address:

Objectives: Non-cirrhotic portal vein thrombosis (PVT) is a main cause of portal hypertension in children. We describe the characteristics at presentation and outcome of a cohort of patients with PVT to determine clinical features and predictors of outcome.

Methods: We recorded: (1) Associated factors: prematurity, congenital malformations, neonatal illnesses, umbilical vein catheterization (UVC), deep infections, surgery; (2) congenital and acquired prothrombotic disorders; (3) features at last follow up including survival rate and need for surgery. Read More

Chin Med J (Engl) 2019 Mar 22. Epub 2019 Mar 22.

Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100005, China.

Background: Portosystemic shunts, including surgical portosystemic shunts and transjugular intrahepatic portosystemic shunts (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.

Methods: Using the terms ["variceal hemorrhage or variceal bleeding or variceal rebleeding" OR "esophageal and gastric varices" OR "portal hypertension"] and "liver cirrhosis", the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Read More

BMJ 2019 Mar 25;364:l536. Epub 2019 Mar 25.

Section of Digestive Diseases, Yale School of Medicine, New Haven, and VA Connecticut Healthcare System, West Haven, Connecticut, CT 06520, USA.

Upper gastrointestinal bleeding (UGIB) is a common medical emergency, with a reported mortality of 2-10%. Patients identified as being at very low risk of either needing an intervention or death can be managed as outpatients. For all other patients, intravenous fluids as needed for resuscitation and red cell transfusion at a hemoglobin threshold of 70-80 g/L are recommended. Read More

Ultraschall Med 2019 Mar 25. Epub 2019 Mar 25.

Gastroenterology, Kurashiki-Central-Hospital, Kurashiki, Japan.

Purpose:  To assess liver stiffness (LS) and spleen stiffness (SS) values measured by virtual touch quantification (VTQ) technique in the monitoring of portal pressure and their usefulness for the prediction of the exacerbation of esophageal varices (EV) in patients with gastric varices undergoing balloon-occluded retrograde transvenous obliteration (B-RTO).

Materials And Methods:  The LS, SS, and hepatic venous pressure gradient (HVPG) were measured in 20 patients both before and after B-RTO. The change in each parameter between the two groups (EV exacerbation and non-exacerbation groups) was compared by analysis of variance. Read More

J Pediatr Gastroenterol Nutr 2019 Mar 18. Epub 2019 Mar 18.

Department of Pediatrics, Columbia University Medical Center, New York, NY.

Objective: There are multiple approaches to manage the clinical complications of portal hypertension (PHTN) to treat/prevent spontaneous hemorrhage by mitigating thrombocytopenia. No single approach is ideal for all patients given the heterogeneity of this population. Our goal was to determine whether partial splenic embolization (PSE) was safe and effective in the pediatric population. Read More

Scand J Gastroenterol 2019 Mar 23:1-8. Epub 2019 Mar 23.

a Department of Gastroenterology and Internal Medicine , Medical University of Bialystok , Bialystok , Poland.

Objective: The study aimed at assessing the effect of thrombocytopenia and platelet function abnormalities on the occurrence of variceal bleeding in patients with cirrhosis.

Methods: The results of impedance aggregometry, von Willebrand factor antigen level and thromboelastometry (TEM) with and without the addition of a platelet inhibitor (FIBTEM, EXTEM test, respectively) were compared in two patient groups: Group 1 (n = 32) - patients with moderate or large esophageal or gastric varices, who had never had symptoms of acute gastrointestinal bleeding and Group 2 (n = 26) - patients with history of variceal bleeding.

Results: Standard clotting test indicated more hypocoagulable profile in Group 2 compared to Group 1. Read More

Clin Case Rep 2019 Mar 28;7(3):452-455. Epub 2019 Jan 28.

Centre for Research and Development Uppsala University/Region Gävleborg Gävle Sweden.

Alcoholic liver cirrhosis leads to portal venous hypertension, which can result in a caput medusae formation. Life-threatening hemorrhage from a ruptured caput medusae vein is a rare complication. It is crucial to stop the bleeding promptly. Read More

J Med Life 2018 Oct-Dec;11(4):355-358

Gastroenterology Department, University of Medicine and Pharmacy, Craiova, Romania.

Adherence to medical treatment in chronic patients challenging, especially in primary prevention where the benefit is not directly perceived by the patient. Through the directed interview of this qualitative study we assessed some specific factors that intervene in beta-blockers adherence in cirrhotic patients with oesophageal varices in primary prevention in Romanian. We identified that the most important modifiable extrinsic factor that influences adherence is the confidence in medicine. Read More

Pediatr Transplant 2019 Mar 19:e13390. Epub 2019 Mar 19.

Service de gastroentérologie et hépatologie pédiatrique, Département de pédiatrie, Cliniques Universitaires Saint-Luc, Bruxelles, Belgique.

Objectives: Cirrhotic children wait-listed for liver transplant are prone to bleeding from gastrointestinal varices. Grade 2-3 esophageal varices, red signs, and gastric varices are well-known risk factors. However, the involvement of hemostatic factors remains controversial because of the rebalanced state of coagulation during cirrhosis. Read More

Scand J Gastroenterol 2019 Mar 17:1-8. Epub 2019 Mar 17.

a Department of Gastroenterology and Gastrointestinal Oncology , University Medical Centre Goettingen , Goettingen , Germany.

Background/aims: Esophageal varices (EV) are common complications in patients with advanced chronic liver disease (ACLD). Non-invasive parameters to exclude EV in patients with ACLD would be desirable. The aim of this study was the evaluation of liver stiffness measurement (LSM) using 2D-shear wave elastography (GE Logiq E9) and other non-invasive parameters as predictors for EV. Read More

J Hepatol 2019 Mar 13. Epub 2019 Mar 13.

Paediatric Liver, GI and Nutrition Centre and Mowatlabs, Kings College Hospital, London, UK.

Background & Aims: In patients with biliary atresia (BA), the rate of native liver survival (NLS) to adulthood has been reported as 14-44% worldwide. Complications related to portal hypertension (PHT) and cholangitis are common in adulthood. For those requiring liver transplantation (LT), the timing can be challenging. Read More

Magy Seb 2019 Mar;72(1):3-7

I. sz. Sebészeti Klinika, Semmelweis Egyetem 1082 Budapest, Üllői út 78.

Introduction: Despite significant development in surgical and intensive therapy, esophageal perforation is still a severe, life-threatening condition. Successful therapy depends on several clinical factors, available medical equipments, but most of all on the available expertise and experience.

Patients And Methods: We retrospectively evaluated patients' data operated at the 1st Department of Surgery at Semmelweis University between 2005 and 2017 due to esophageal perforation of non-malignant origin. Read More

Indian J Gastroenterol 2019 Feb 14;38(1):69-76. Epub 2019 Mar 14.

Department of Medicine, B R Singh Hospital, Kolkata, 700 014, India.

Background: There are scanty data on the long-term outcome of endoscopic variceal band ligation (EVL) for esophageal varices.

Methods: Adult patients suffering from a chronic liver disease (CLD) undergoing EVL of esophageal varices of grade 2 and above between January 2006 and December 2015 were followed up for the recurrence of varices, worsening of portal hypertensive gastropathy (PHG), rebleeding, and mortality. EVL was done as primary prophylaxis of bleeding in 72 and as secondary prophylaxis in 175 patients. Read More

World J Gastroenterol 2019 Mar;25(9):1088-1099

Department of Ultrasound, Air Force Medical Center of PLA, Beijing 100142, China.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is currently used for the treatment of complications of portal hypertension. The incidence of hepatic encephalopathy (HE) remains a problem in TIPS placement. It has been reported that the right branch mainly receives superior mesenteric venous blood while the left branch mainly receives blood from the splenic vein. Read More

Hepatol Commun 2019 Mar 9;3(3):382-391. Epub 2019 Jan 9.

Pediatric Liver and Gut Research Group and Section of Pediatric Surgery Children's Hospital, Helsinki University Hospital Helsinki Finland.

We investigated noninvasive follow-up markers for histologic liver fibrosis and portal hypertension (PH) in patients with biliary atresia after successful portoenterostomy (PE). Among children with bilirubin <20 µmol/L after PE (n = 39), Metavir fibrosis stage was evaluated at PE and in follow-up protocol liver biopsies (n = 83). PH was defined as endoscopically confirmed esophageal varices or thrombocytopenia associated with splenomegaly. Read More

J Cardiothorac Vasc Anesth 2019 Feb 10. Epub 2019 Feb 10.

Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE.

Liver transplantation (LT) continues to be the gold standard for treating end-stage liver disease, and challenges that are posed to the anesthesiologist during transplantation are well known. Successful liver transplantation requires knowledge, recognition, and treatment of hemodynamic and metabolic disturbances by the anesthesiologist. End-stage liver disease causes unique derangements to the clotting cascade, increasing risk both for hemorrhagic and thrombotic events. Read More

Updates Surg 2019 Mar 9;71(1):57-66. Epub 2019 Mar 9.

Department of Hepatobiliary and General Surgery, Humanitas Clinical and Research Center - IRCCS, Humanitas University, Via Manzoni, 56, Rozzano, 20089, Milan, Italy.

Whether hepatic resection for multinodular hepatocellular carcinoma (HCC) is indicated remains to be demonstrated. We investigated the prognostic factors in a large series of patients treated with hepatic resection at a reference cancer center. All consecutive patients resected for multinodular HCC from January 2004 to April 2015 were reviewed. Read More

J Am Soc Echocardiogr 2019 Mar 4. Epub 2019 Mar 4.

Division of Cardiovascular Medicine, Ohio State University, Columbus, OH.

Gastrointest Endosc Clin N Am 2019 Apr;29(2):321-337

Interventional Endoscopy Services, California Pacific Medical Center, 2351 Clay Street, 6th Floor Suite 600, San Francisco, CA 94115, USA.

Gastrointestinal bleeding as a sequela of portal hypertension can be catastrophic and fatal. Endoscopic and endosonographic therapy play a critical role in management of such bleeding- both for hemostasis of active bleeding and bleeding prophylaxis. Variceal band ligation is established as the standard intervention for esophageal varices. Read More

Surg Clin North Am 2019 Apr;99(2):387-401

General Surgery, University of Alabama at Birmingham, 1808 7th Avenue South D202 Boshell Building Birmingham, Alabama 35233, USA; Division of Transplantation, University of Alabama at Birmingham, 701 19th Street South 722 Lyons Harrison Birmingham, Alabama 35233. Electronic address:

Orthotopic liver transplantation (OLT) has many roles in biliary disease. OLT provides excellent results for patients with unresectable hilar cholangiocarcinoma. OLT prolongs survival in primary biliary cirrhosis not responsive to therapy and improves quality of life. Read More

Exp Clin Transplant 2019 Mar 5. Epub 2019 Mar 5.

From the Shiraz Organ Transplantation Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: Liver transplant has been used as a curative approach for children with end-stage liver diseases. Here, we describe the underlying causes for pediatric liver transplant performed at the Shiraz Organ Transplantation Center, Nemazee Hospital, Shiraz, Iran.

Materials And Methods: In this cross-sectional des-criptive study, children < 18 years old who were candidates for liver transplant from 2007 to 2010 at the Shiraz Organ Transplantation Center were included. Read More

World J Gastroenterol 2019 Feb;25(8):888-908

Liver Unit/Division of Integrative Systems Medicine and Digestive Disease, Imperial College London, London W2 1NY, United Kingdom.

Due to the restrictions of liver transplantation, complication-guided pharmacological therapy has become the mainstay of long-term management of cirrhosis. This article aims to provide a complete overview of pharmacotherapy options that may be commenced in the outpatient setting which are available for managing cirrhosis and its complications, together with discussion of current controversies and potential future directions. PubMed/Medline/Cochrane Library were electronically searched up to December 2018 to identify studies evaluating safety, efficacy and therapeutic mechanisms of pharmacological agents in cirrhotic adults and animal models of cirrhosis. Read More

Endoscopy 2019 Apr 1;51(4):360-364. Epub 2019 Mar 1.

National Clinical Research Center for Digestive Diseases; Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.

Background:  Esophageal capsule endoscopy is reported to be insufficiently accurate to replace esophagogastroduodenoscopy (EGD) because the passage of the capsule through the esophagus is passive and precludes a thorough investigation. We developed a modified capsule endoscopy technique, called detachable string magnetically controlled capsule endoscopy (DS-MCE), and performed a pilot study to assess the feasibility and safety of this novel technique.

Methods:  4 healthy volunteers and 21 patients with suspected esophageal disease first underwent DS-MCE followed by EGD within 1 week. Read More

Dig Endosc 2019 Mar 1. Epub 2019 Mar 1.

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Am Surg 2019 Feb;85(2):e108-e110

BMC Gastroenterol 2019 Feb 28;19(1):37. Epub 2019 Feb 28.

Liver Transplant Program, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Background: Endoscopic injection sclerotherapy (EIS) is a life-saving procedure for pediatric patients with bleeding gastric varices (GV) associated with advanced liver cirrhosis and severe portal hypertension. Because of the lack of an endoscopic banding ligation device for pediatric patients, EIS is usually performed for bleeding esophageal varices (EV) in infants with congenital biliary atresia.

Case Presentation: We present a case of a 15-month-old female infant with type I biliary atresia with jaundice (total serum bilirubin, 22. Read More

Medicine (Baltimore) 2019 Mar;98(9):e14615

Department of Liver Disease, Dalian Sixth People Hospital, Dalian 116031.

This study aims to investigate the value and determine the accuracy of spleen stiffness in predicting the degree of esophageal varices and bleeding in patients with liver cirrhosis.The age, gender, liver stiffness, spleen stiffness, and gastroscopy results of 124 inpatients or outpatients with liver cirrhosis and healthy volunteers, who underwent both gastroscopy and FibroScan testing in the fasting state, were retrospectively analyzed. According to the gastroscopy results, the patients and healthy volunteers were divided into six groups: varicose bleeding, severe varices, moderate varices, mild varices, no varices, and healthy control group. Read More

Eur Radiol 2019 Feb 22. Epub 2019 Feb 22.

Gastroenterology Department II or Hepatology Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, 650101, Yunnan Province, China.

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) and partial splenic embolization (PSE) were two interventional radiological treatments for the complications of cirrhosis. This study aimed to investigate the effects of concomitant PSE on the long-term shunt patency and overall survival of TIPS-treated patients.

Methods: Forty-eight patients with TIPS insertion were enrolled and studied retrospectively. Read More

Liver Int 2019 Feb 21. Epub 2019 Feb 21.

Division of Gastroenterology and Hepatology, Weill Cornell Medicine - New York-Presbyterian Hospital, New York, New York.

Background & Aims: Cirrhotics are at increased risk of Clostridioides difficile infection (CDI) and its associated high morbidity and mortality. However, the impact of CDI in cirrhotics over time remains unclear. This study analyses prevalence and mortality in CDI in hospitalized patients with advanced cirrhosis over 15 years and identifies trends. Read More

Cardiovasc Intervent Radiol 2019 May 20;42(5):729-736. Epub 2019 Feb 20.

Department of Gastroenterology, University Hospital of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.

Adjuvant embolization of varices may reduce rebleeding in patients with a transjugular intrahepatic portosystemic shunt (TIPS). The aim of this study was to investigate the efficacy and the risks of adjuvant variceal embolization at TIPS implantation using bucrylate.

Patients And Methods: The retrospective study evaluated 104 of 237 cirrhotic patients with TIPS for variceal bleeding who received adjuvant bucrylate embolization. Read More

Arq Gastroenterol 2018 Oct-Dec;55(4):338-342

Universidade Federal de Minas Gerais, Hospital das Clínicas, Belo Horizonte, MG, Brasil.

Background: Gastroesophageal varices and associated bleeding are a major cause of morbidity and mortality in cirrhotic patients.

Objective: To evaluate the potential role of the biomarkers HMGB1 (High Mobility Group Box 1) and IL-6 (Interleukin-6) as predictors of infection, acute kidney injury and mortality in these patients.

Methods: It is a prospective, observational study that included 32 cirrhotic patients with variceal bleeding. Read More

Arq Gastroenterol 2018 Oct-Dec;55(4):329-337

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brasil.

Background: Infection by hepatitis C virus is one of the leading causes of chronic hepatitis C and cause severe burden for patients, families and the health care system.

Objective: The aims of this research were to assess the severity of liver fibrosis, comorbidities and complications of hepatitis C virus; to examine health-related quality of life (HRQoL), productivity loss and resource use and costs in a sample of Brazilian chronic hepatitis C, genotype 1, patients.

Methods: This was a cross-sectional multicenter study performed in genotype-1 chronic hepatitis C patients to assess disease burden in the Brazilian public health care system between November 2014 and March 2015. Read More

BMC Gastroenterol 2019 Feb 19;19(1):32. Epub 2019 Feb 19.

Department of Gastroenterology and Hepatology, Beijing You An Hospital affiliated to the Capital Medical University, 8 Xi Tou Tiao, Youanmen wai, Beijing, 100069, China.

Background: The recurrence of esophageal varices remains high in patients with hepatic portal hypertension after the endoscopic esophageal variceal eradication therapies, including endoscopic variceal band ligation (EVL), injection sclerotherapy (EIS) or EVL plus EIS. The aim of this study was to evaluate the endoscopic ultrasound probe examinations (EUP) findings in the prediction of recurrence following esophageal variceal eradication in a prospective cohort.

Methods: A total of 206 cirrhotic portal hypertension patients with esophageal variceal eradication, who underwent endoscopic variceal therapy (EVL or EIS or EVL plus EIS) were initially enrolled. Read More

Gastroenterology 2019 03 15;156(4):864-866. Epub 2019 Feb 15.

University of Milan, Milan, Italy. Electronic address:

Ther Clin Risk Manag 2019 29;15:191-200. Epub 2019 Jan 29.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China,

Objective: Variceal hemorrhage is the primary driver of mortality in patients with portal hypertension. Recent guidelines recommended that patients with esophageal varices should receive endoscopic band ligation (EBL) or carvedilol as prophylaxis of variceal bleeding. Several clinical trials have compared carvedilol use with EBL intervention, yielding controversial results. Read More

Gastroenterology 2019 03 13;156(4):997-1009.e5. Epub 2019 Feb 13.

AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, Université Paris 13, Bobigny et INSERM U1162, Université Paris 5, Paris.

Background & Aims: Management of patients with cirrhosis includes endoscopic screening and surveillance to detect esophageal varices (EV) and prevent bleeding. However, the Baveno VI guidelines recommend avoiding endoscopies for patients with liver stiffness measurements below 20 kPa and platelet counts above 150,000 (favorable Baveno VI status) and endoscopic assessment of patients with higher levels of liver stiffness and platelet counts (unfavorable Baveno VI status). We aimed to validate the Baveno VI guidelines, evaluating outcomes of patients in the ANRS-CO12 CirVir cohort with compensated cirrhosis associated with hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, with or without a sustained response to antiviral therapy. Read More