Hemodynamic assessment in clinical practice in portal hypertensive cirrhotics

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Annals of Gastroenterology
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Hemodynamic assessment in clinical practice in portal hypertensive cirrhotics (EN)

Groszmann R.,
Wongcharatrawee S.,

SUMMARY With the advent of the balloon catheter technique for the measurement of HVPG, portal hemodynamics can be studied safely, conveniently and accurately. Evaluation of portal hemodynamics not only provides information in diagnosing the etiologies of portal hypertension, it is also essential in evaluating efficacy of various treatments for this devastating syndrome. Furthermore, HVPG has also been shown to correlate with survival prognosis in patients with end-stage liver disease. In light of the current shortage of donor organs, the role of HVPG in classification of liver transplantation candidates should be worth future investigation. In addition, although HVPG by itself is not a reliable predictor of variceal hemorrhage, it has been suggested that serial measurements of HVPGs may be a better risk prognosticator. This issue also deserves further investigation. Recently, HVPG has assumed an importance in the pre-operative assessment in cirrhotics, even though this prognostic value was derived from a specific situation, hepatic resection in early HCC. Before a definite recommendation can be made regarding other types of surgery, future studies should compare HVPG with conventional tools such as Child/Pugh classification score. Lastly, non-invasive methods of quantitative portal hemodynamic measure-ment should be compared directly with HVPG in order to further define their roles in the evaluation of portal hypertension. Key Words: portal hypertension, hepatic venous pressure gradient, esophageal varices, variceal hemorrhage, hepatocellular carcinoma, cirrhosis (EN)


Αγγλική γλώσσα


Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 14, No 3 (2001) (EN)

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