Invasive measurement of portal hypertension in the hemodynamics laboratory as an important element of qualification for the treatment of esophageal varices: A single-center experience

Abstract

Introduction: The measurement of hepatic venous pressure gradient (HVPG) is an essential prognostic factor in subjects with chronic liver disorders. Aim: The present study aimed to present the feasibility and applicability of HVPG in the modern hemodynamics laboratory in patients with liver cirrhosis as a stage for qualification in variceal band ligation (VBL). Material and methods: We included 78 patients with liver cirrhosis and esophageal varices, who had HVPG measurements taken at the hemodynamics laboratory between January 2015 and January 2019. Results and discussion: The mean age was 55.5 ± 10.9 years, and 66.7% were males. The most common cause of liver cirrhosis was alcohol abuse (65.4%), and the most common varices stage was 3 (83.3%). The mean HVPG was 16.3 ± 6.2 mm Hg. In total, 67 (85.9%) patients had HVPG over 10 mm Hg and underwent VBL. No periprocedural complications were observed. At 12 months, recurrent hospitalizations were observed in 67 (85.9%), 5 (6.4%)had cirrhosis-related bleeding episodes, and 4 (5.1%) patients died. Conclusions: HVPG measurement is a feasible, safe and reproducible procedure that provides valuable diagnostic/prognostic information and helps make therapeutic decisions. This procedure can be done quickly in the modern hemodynamics laboratory.