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World J Gastroenterol. Nov 7, 2026; 32(41): 121668
Published online Nov 7, 2026. doi: 10.3748/wjg.121668
Published online Nov 7, 2026. doi: 10.3748/wjg.121668
Gastric variceal pressure gradient in patients with large spontaneous shunts: A novel approach to local hemodynamic assessment
Wei Wei, Meng Xue, Li-Yi Xu, Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Co-first authors: Wei Wei and Meng Xue.
Author contributions: Wei W conceived and designed the study, obtained funding, developed the methodology, curated the data, and drafted the manuscript; Xue M contributed to the study design, curated the data, supervised the study, and participated in manuscript preparation; Xu LY curated the data, performed the formal analysis, and critically revised the manuscript; Wei W and Xue M contributed equally to this work and share first authorship; all authors have read and approved the final manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the Chronic Disease Management Research Project of National Health Commission Capacity Building and Continuing Education Center, No. GWJJMB202510025159; and the Medical and Health Science Program of Zhejiang Province, No. 2025HY0403.
Institutional review board statement: The study was approved by the Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval No. 2025-0822).
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Corresponding author: Li-Yi Xu, MD, Doctor, Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Shang
Received: April 9, 2026
Revised: June 23, 2026
Accepted: July 15, 2026
Published online: November 7, 2026
Processing time: 164 Days and 9.9 Hours
Revised: June 23, 2026
Accepted: July 15, 2026
Published online: November 7, 2026
Processing time: 164 Days and 9.9 Hours
Core Tip
Core Tip: In patients with large spontaneous portosystemic shunts, the hepatic venous pressure gradient may underestimate the risk of bleeding because of shunt-mediated decompression. The gastric variceal pressure gradient, reflecting local variceal hemodynamics, may provide additional value for risk stratification.