Letters To The Editor
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World J Gastroenterol. Jun 21, 2014; 20(23): 7523-7524
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7523
Hepatic venous pressure gradient measurement before TIPS for acute variceal bleeding
Xing-Shun Qi, Dai-Ming Fan
Xing-Shun Qi, Dai-Ming Fan, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, 710032, Shaanxi Province, China
Xing-Shun Qi, Department of Gastroenterology, No. 463 Hospital of Chinese PLA, Shenyang 110045, Liaoning Province, China
Author contributions: Qi XS conceived and drafted the paper; Fan DM revised this paper.
Correspondence to: Dai-Ming Fan, MD, PhD, Professor, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 27 West Changle Road, Xi’an 710032, Shaanxi Province, China. fandaim@fmmu.edu.cn
Telephone: +86-29-84771537 Fax: +86-29-82539041
Received: October 8, 2013
Revised: January 12, 2014
Accepted: March 4, 2014
Published online: June 21, 2014
Abstract

Hepatic venous pressure gradient (HVPG) is an independent predictor of variceal rebleeding in patients with cirrhosis. After pharmacological and/or endoscopic therapy, the use of a transjugular intrahepatic portosystemic shunt (TIPS) may be necessary in HVPG non-responders, but not in responders. Thus, HVPG measurement may be incorporated into the treatment algorithm for acute variceal bleeding, which further identifies the candidates that should undergo early insertion of TIPS or maintain the traditional pharmacological and/or endoscopic therapy. The potential benefits are to reduce the cost and prevent TIPS-related complications.

Keywords: Acute variceal bleeding, Transjugular intrahepatic portosystemic shunt, Hepatic venous pressure gradient, Liver cirrhosis

Core tip: If hepatic venous pressure gradient could be measured before a transjugular intrahepatic portosystemic shunt for the treatment of acute variceal bleeding, the invasiveness of treatment strategy would be further decreased.