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Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function

OBJECTIVES: To identify patients suitable for endoscopic injection sclerotherapy (EIS) by evaluating their portal hemodynamics and liver function. METHODS: We selected 58 patients with esophagogastric varices (EGV) and liver cirrhosis (LC) related to either hepatitis C virus (C) (n = 19), hepatitis...

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Autores principales: Shigefuku, Ryuta, Takahashi, Hideaki, Watanabe, Tsunamasa, Hattori, Nobuhiro, Ikeda, Hiroki, Matsunaga, Kotaro, Ehira, Takuya, Suzuki, Tatsuya, Matsumoto, Nobuyuki, Okuse, Chiaki, Iwasa, Motoh, Nakagawa, Hayato, Itoh, Fumio, Suzuki, Michihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9306194/
https://www.ncbi.nlm.nih.gov/pubmed/35864442
http://dx.doi.org/10.1186/s12876-022-02422-7
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author Shigefuku, Ryuta
Takahashi, Hideaki
Watanabe, Tsunamasa
Hattori, Nobuhiro
Ikeda, Hiroki
Matsunaga, Kotaro
Ehira, Takuya
Suzuki, Tatsuya
Matsumoto, Nobuyuki
Okuse, Chiaki
Iwasa, Motoh
Nakagawa, Hayato
Itoh, Fumio
Suzuki, Michihiro
author_facet Shigefuku, Ryuta
Takahashi, Hideaki
Watanabe, Tsunamasa
Hattori, Nobuhiro
Ikeda, Hiroki
Matsunaga, Kotaro
Ehira, Takuya
Suzuki, Tatsuya
Matsumoto, Nobuyuki
Okuse, Chiaki
Iwasa, Motoh
Nakagawa, Hayato
Itoh, Fumio
Suzuki, Michihiro
author_sort Shigefuku, Ryuta
collection PubMed
description OBJECTIVES: To identify patients suitable for endoscopic injection sclerotherapy (EIS) by evaluating their portal hemodynamics and liver function. METHODS: We selected 58 patients with esophagogastric varices (EGV) and liver cirrhosis (LC) related to either hepatitis C virus (C) (n = 19), hepatitis B virus (n = 2), alcohol (AL) (n = 20), C + AL (n = 6), non-alcoholic steatohepatitis (n = 6), others (n = 3), or non-LC (n = 2). All patients underwent EIS. We measured their portal venous tissue blood flow (PVTBF) and hepatic arterial tissue blood flow (HATBF) using xenon computed tomography before and after EIS. We classified them into increased group and decreased group according to the PVTBF to identify the predictors that contribute to PVTBF increase post-EIS. RESULTS: Low value of indocyanine green retention at 15 min (ICG-R(15)), the absence of paraesophageal veins, and low baseline PVTBF/HATBF (P/A) ratio predicted increased PVTBF in the multivariate logistic analysis (odds ratio (OR) 10.46, p = 0.0391; OR 12.45, p = 0.0088; OR 13.57, p = 0.0073). The protein synthetic ability improved 1 year post-EIS in increased group. Cox proportional hazards regression identified alcohol drinking (hazard ratio; 3.67, p = 0.0261) as an independent predictor of EGV recurrence. CONCLUSIONS: Patients with low ICG-R(15), low P/A ratio, and the absence of paraesophageal veins were probable predictors of PVTBF improvement post-EIS. In addition, the improvement of hepatic hemodynamics likely enhanced liver function following EIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02422-7.
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spelling pubmed-93061942022-07-23 Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function Shigefuku, Ryuta Takahashi, Hideaki Watanabe, Tsunamasa Hattori, Nobuhiro Ikeda, Hiroki Matsunaga, Kotaro Ehira, Takuya Suzuki, Tatsuya Matsumoto, Nobuyuki Okuse, Chiaki Iwasa, Motoh Nakagawa, Hayato Itoh, Fumio Suzuki, Michihiro BMC Gastroenterol Research OBJECTIVES: To identify patients suitable for endoscopic injection sclerotherapy (EIS) by evaluating their portal hemodynamics and liver function. METHODS: We selected 58 patients with esophagogastric varices (EGV) and liver cirrhosis (LC) related to either hepatitis C virus (C) (n = 19), hepatitis B virus (n = 2), alcohol (AL) (n = 20), C + AL (n = 6), non-alcoholic steatohepatitis (n = 6), others (n = 3), or non-LC (n = 2). All patients underwent EIS. We measured their portal venous tissue blood flow (PVTBF) and hepatic arterial tissue blood flow (HATBF) using xenon computed tomography before and after EIS. We classified them into increased group and decreased group according to the PVTBF to identify the predictors that contribute to PVTBF increase post-EIS. RESULTS: Low value of indocyanine green retention at 15 min (ICG-R(15)), the absence of paraesophageal veins, and low baseline PVTBF/HATBF (P/A) ratio predicted increased PVTBF in the multivariate logistic analysis (odds ratio (OR) 10.46, p = 0.0391; OR 12.45, p = 0.0088; OR 13.57, p = 0.0073). The protein synthetic ability improved 1 year post-EIS in increased group. Cox proportional hazards regression identified alcohol drinking (hazard ratio; 3.67, p = 0.0261) as an independent predictor of EGV recurrence. CONCLUSIONS: Patients with low ICG-R(15), low P/A ratio, and the absence of paraesophageal veins were probable predictors of PVTBF improvement post-EIS. In addition, the improvement of hepatic hemodynamics likely enhanced liver function following EIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02422-7. BioMed Central 2022-07-21 /pmc/articles/PMC9306194/ /pubmed/35864442 http://dx.doi.org/10.1186/s12876-022-02422-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Shigefuku, Ryuta
Takahashi, Hideaki
Watanabe, Tsunamasa
Hattori, Nobuhiro
Ikeda, Hiroki
Matsunaga, Kotaro
Ehira, Takuya
Suzuki, Tatsuya
Matsumoto, Nobuyuki
Okuse, Chiaki
Iwasa, Motoh
Nakagawa, Hayato
Itoh, Fumio
Suzuki, Michihiro
Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
title Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
title_full Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
title_fullStr Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
title_full_unstemmed Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
title_short Effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
title_sort effects of endoscopic injection sclerotherapy for esophagogastric varices on portal hemodynamics and liver function
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9306194/
https://www.ncbi.nlm.nih.gov/pubmed/35864442
http://dx.doi.org/10.1186/s12876-022-02422-7
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