Primary prophylaxis of variceal bleeding in cirrhotic patients: A cohort study

Dell’Era, Alessandra; Sotela, J. Cubero; Fabris, F; Petazzi, G.; Reati, R.; Iannuzzi, Francesca; Nicolini, Antonio; Rumi, Maria Grazia; Franchis, Roberto de; Primignani, Massimo

doi:10.1016/j.dld.2008.03.017

Cited by 21 publications

(15 citation statements)

References 14 publications

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“…In a cohort study 43 the usefulness of a strategy in which band ligation was used to treat 135 patients with contraindications or intolerance and patients not responding to beta‐blockers (identified by hepatic vein pressure gradient measurement) was assessed. These patients achieved protection from variceal bleeding comparable to that of good responders to beta‐blockers.…”

Section: Primary Prophylaxis Of Portal Hypertensive Bleedingmentioning

confidence: 99%

Review article: the therapeutic and prognostic benefit of portal pressure reduction in cirrhosis

Triantos

Nikolopoulou

Burroughs

2008

Aliment Pharmacol Ther

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Section: Primary Prophylaxis Of Portal Hypertensive Bleedingmentioning

confidence: 99%

Review article: the therapeutic and prognostic benefit of portal pressure reduction in cirrhosis

Triantos

Nikolopoulou

Burroughs

2008

Aliment Pharmacol Ther

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“…The probability of bleeding at 3 years was significantly higher in poor responders than in good responders ( P =0.0008). In a cohort study,45 the usefulness of a strategy in which EBL was used to treat 135 patients was assessed. These patients achieved protection from variceal bleeding comparable to that of good responders to beta-blockers.…”

Section: Introductionmentioning

confidence: 99%

Hepatic venous pressure gradient: clinical use in chronic liver disease

Suk

2014

Clin Mol Hepatol

119

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Portal hypertension is a severe consequence of chronic liver diseases and is responsible for the main clinical complications of liver cirrhosis. Hepatic venous pressure gradient (HVPG) measurement is the best available method to evaluate the presence and severity of portal hypertension. Clinically significant portal hypertension is defined as an increase in HVPG to >10 mmHg. In this condition, the complications of portal hypertension might begin to appear. HVPG measurement is increasingly used in the clinical fields, and the HVPG is a robust surrogate marker in many clinical applications such as diagnosis, risk stratification, identification of patients with hepatocellular carcinoma who are candidates for liver resection, monitoring of the efficacy of medical treatment, and assessment of progression of portal hypertension. Patients who had a reduction in HVPG of ≥20% or to ≤12 mmHg in response to drug therapy are defined as responders. Responders have a markedly decreased risk of bleeding/rebleeding, ascites, and spontaneous bacterial peritonitis, which results in improved survival. This review provides clinical use of HVPG measurement in the field of liver disease.

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“…Indeed, it is expected that only a limited number of the poor responders will undergo a variceal bleeding, and, at least within the context of primary prophylaxis, the majority will not bleed during follow-up; conversely, it is very important from a clinical point of view to minimize the number of the patients classified as good responders who actually bleed. In the latter situation, the classification error bears relevant clinical consequences, as the use of an ineffective treatment, which is believed to be effective, prevents us from using an alternative treatment which may be more effective [10,11]. From the present report it appears that most classification errors are of the first type (poor responders who do not bleed during followup), even though exact values are not provided.…”

Section: See Article Pages 279-287mentioning

confidence: 43%