EUS-guided portal pressure gradient measurement for evaluating the severity of portal hypertension: A retrospective analysis

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Abstract Background and Objectives EUS-guided portal pressure gradient (EUS-PPG) measurement has been proposed as a novel direct manometry to quantify portal hypertension. This study aimed to explore the ability of EUS-PPG measurements to evaluate the severity of portal hypertension. Methods The clinical features of patients with diagnosed cirrhosis or chronic liver disease who underwent EUS-PPG measurement at a single center were retrospectively analyzed. The correlations between the clinical features of portal hypertension and the EUS-PPG measurements were analyzed, and then receiver operating characteristic curves were used to evaluate the ability of the EUS-PPG measurements to evaluate disease severity. Results A total of 197 patients were included in this study. The EUS-PPG measurements varied significantly among patients categorized by gastroesophageal varices, red signs, variceal bleeding, ascites, hepatic encephalopathy, thrombocytopenia, hypoproteinemia, prothrombin time, international normalized ratio, or Child-Pugh grade ( P < 0.05). The areas under the receiver operating characteristic curves for gastroesophageal varices, decompensated cirrhosis, ascites, and recent variceal bleeding were 0.919, 0.847, 0.813, and 0.804, respectively ( P < 0.001). Furthermore, the optimal EUS-PPG cutoff values for gastroesophageal varices, decompensated cirrhosis, ascites, and recent variceal bleeding were 11.5 mm Hg (sensitivity = 80.3%, specificity = 89.5%), 12.75 mm Hg (sensitivity = 77.8%, specificity = 76.7%), 15.75 mm Hg (sensitivity = 66.7%, specificity = 83.1%), and 16.75 mm Hg (sensitivity = 76.2%, specificity = 70.1%), respectively. Conclusions EUS-PPG measurement seems to be an effective technique for assessing disease severity and risk of variceal bleeding in patients with diagnosed cirrhosis or chronic liver disease.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.