Abstract
Background and PurposeRecently, we invented a computerized endoscopic balloon manometry (CEBM) to measure variceal pressure (VP) in cirrhotic patient. The purpose of this study was to evaluate the reliability and feasibility of this method, and whether this technique provided further information to pharmacological therapy.Patients and MethodsVP measurements were performed in 83 cirrhotic patients and compared with HVPG as well as endoscopic bleeding risk parameters. Furthermore, VP was assessed before and during propranolol therapy in 30 patients without previous bleeding.ResultsVP measurements were successful in 96% (83/86) of all patients. Of the 83 patients, the VP correlated closely with the HVPG (P<0.001). The presence of red colour signs and the size of varices were strongly associated with VP. Patients with previous bleeding had higher VP than those who had not yet experienced bleeding. In univariate analysis, the level of VP, the size of varices, and red color signs predicted a higher risk of bleeding. The multiple logistic regression model revealed that VP was the major risk factor for bleeding. In 30 patients receiving propranolol, VP significantly decreased from 21.1±3.5 mmHg before therapy to 18.1±3.3 mmHg after 3 months and to 16.3±4.0 mmHg after 6 months. Comparing the mean decrease in VP with that in hepatic venous pressure gradient (HVPG), the decrease in VP was more obvious than HVPG response to propranolol.ConclusionsThis study showed that CEBM is safe and practical to assess VP in cirrhotic patient. It has the potential to be used as a clinical method to assess the risk of variceal bleeding and the effects of pharmacological therapy.Trial registrationEffect of vasoactive drugs on esophageal variceal hemodynamics in patients with portal hypertension. Chinese Clinical Trial Registry –TRC-08000252.
Highlights
Previous studies have revealed that variceal pressure VP is a major predictor of variceal bleeding risk and of the response to pharmacological therapy in patients with portal hypertension [1,2,3,4]
This study showed that computerized endoscopic balloon manometry (CEBM) is safe and practical to assess VP in cirrhotic patient
It has the potential to be used as a clinical method to assess the risk of variceal bleeding and the effects of pharmacological therapy
Summary
Previous studies have revealed that variceal pressure VP is a major predictor of variceal bleeding risk and of the response to pharmacological therapy in patients with portal hypertension [1,2,3,4]. VP is considered as the pressure needed by the balloon to cause the disappearance of flow inside the varix during its compression This modified method has suggested its reliability and accuracy in vitro studies, but clinical studies are still lacked. We invented a computerized endoscopic balloon manometry (CEBM), with computer vision to determine the moment of variceal wall collapse instead of direct vision using in the traditional method [10]. In the study, we aimed to determine whether the CEBM was a safe and reliable method to evaluate VP, an important parameter related to the risk of variceal bleeding, and to evaluate the effectiveness of pharmaceutical therapy in patients with portal hypertension. The purpose of this study was to evaluate the reliability and feasibility of this method, and whether this technique provided further information to pharmacological therapy
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
