Gastric variceal pressure gradient in patients with large spontaneous shunts: A novel approach to local hemodynamic assessment

doi:10.3748/wjg.121668

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Nov 7, 2026; 32(41): 121668
Published online Nov 7, 2026. doi: 10.3748/wjg.121668

Table 1 Demographic and clinical characteristics of the patients (n = 25), mean ± SD/n (%)

Characteristics	Patients enrolled
Age, years	58 ± 14
Male sex	18 (72)
BMI, kg/m²	21.57 ± 3.44
Hypertension	5 (20)
Diabetes	3 (12)
Etiology of liver cirrhosis
Viral hepatitis	18 (72)
Alcohol	1 (4)
Other	6 (24)
Laboratory values (median, Q1-Q3)
ALT (U/L)	26.00 (18.00-39.50)
AST (U/L)	35.00 (29.50-45.00)
ALB (g/L)	35.80 (31.75-38.85)
TB (μmol/L)	19.00 (14.50-24.90)
PLT (10⁹/L)	79.00 (51.50-137.00)
PT (second)	15.00 (14.05-16.20)
INR	1.18 (1.10-1.31)
Oesophageal varices	13 (52)
Ascites	11 (44)
Child-Pugh score
A	18 (72)
B	7 (28)
MELD score (median, Q1-Q3)	9 (7.0-12.0)
MELD-Na (median, Q1-Q3)	9 (8.0-10.5)

BMI: Body mass index; ALT: Alanine transaminase; AST: Aspartate transaminase; ALB: Albumin; TB: Total bilirubin; PLT: Platelet; PT: Prothrombin time; INR: International normalized ratio; MELD: Model for end-stage liver disease; MELD-Na: Model for end-stage liver disease-sodium.

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Table 2 Characteristics of gastric varices in patients (n = 25), mean ± SD/n (%)

Characteristics	Patients enrolled
GEVs classification
IGV1	14 (56)
IGV1 + GOV1	6 (24)
GOV2	5 (20)
Portosystemic shunt
Gastro-renal shunt	19 (76)
Spleen-renal shunt	6 (24)
Diameter of gastric varices, cm	2.68 ± 0.79
Diameter of the portosystemic shunt, cm	1.29 ± 0.31
Diameter of portal vein, cm	1.47 ± 0.19
HVPG
HVPG (mmHg)	6.16 ± 2.56
FHVP (mmHg)	13.36 ± 5.52
WHVP (mmHg)	19.80 ± 7.10
EUS-PPG
PPG (mmHg)	9.04 ± 5.74
IVCP (mmHg)	10.72 ± 4.73
PVP (mmHg)	19.84 ± 7.94
GVPG (mmHg)	16.32 ± 6.18
GVP (mmHg)	27.04 ± 7.67
Variceal bleeding ≤ 4 weeks	16 (64)

GEVs: Gastroesophageal varices; IGV: Isolated gastric varices; GOV: Gastro-oesophageal varices; HVPG: Hepatic venous pressure gradient; FHVP: Free hepatic venous pressure; WHVP: Wedged hepatic venous pressure; EUS-PPG: Endoscopic ultrasound-guided portal pressure gradient; PPG: Portal pressure gradient; IVCP: Inferior vena cava pressure; PVP: Portal vein pressure; GVPG: Gastric varices pressure gradient; GVP: Gastric varices pressure.

Full Size Table

Table 3 Characteristics of gastric varices in patients (n = 25), mean ± SD/n (%)

Characteristics	No recent bleeding (n = 10)	Recent bleeding (n = 15)	P value
Age, years	61.40 ± 12.50	57.33 ± 15.18	0.470
Male sex	7 (70.00)	11 (73.33)	0.856
BMI, kg/m²	20.95 ± 2.20	21.99 ± 4.10	0.560
Etiology of liver cirrhosis			0.090
Viral hepatitis	4 (40.00)	13 (86.67)
Alcohol	1 (10.00)	0 (0)
Other	5 (50.00)	2 (13.33)
Child-Pugh score			0.659
A	8 (80.00)	10 (66.67)
B	2 (20.00)	5 (33.33)
MELD score (median, Q1-Q3)	8 (7.0-13.0)	10 (9.0-12.0)	0.382
MELD-Na (median, Q1-Q3)	8 (7.0-10.5)	9 (9.0-11.0)	0.160
Non-selective beta-blockers	5 (50.00)	9 (60.00)	0.244
GEVs classification			0.206
IGV1	8 (80.00)	6 (40.00)
IGV1 + GOV1	1 (10.00)	5 (33.33)
GOV2	1 (10.00)	4 (26.67)
Portosystemic shunt			0.653
Gastro-renal shunt	7 (70.00)	12 (80.00)
Splenorenal shunt	3 (30.00)	3 (20.00)
Diameter of gastric varices, cm	2.38 ± 0.71	2.87 ± 0.80	0.137
Diameter of the portosystemic shunt, cm	1.13 ± 0.23	1.39 ± 0.31	0.034^a
Diameter of portal vein, cm	15.42 ± 1.71	14.16 ± 1.91	0.080
PVP, mmHg	19.10 ± 9.70	20.33 ± 6.86	0.420
IVCP, mmHg	12.20 ± 5.55	9.73 ± 4.00	0.317
GVP, mmHg	25.40 ± 9.40	28.13 ± 6.38	0.156
HVPG, mmHg	5.00 ± 2.45	6.93 ± 2.40	0.054
PPG, mmHg	6.70 ± 5.18	10.60 ± 5.73	0.075
GVPG, mmHg	13.20 ± 5.13	18.40 ± 6.07	0.030^a

^aP < 0.05.

BMI: Body mass index; MELD: Model for end-stage liver disease; MELD-Na: Model for end-stage liver disease-sodium; GEVs: Gastroesophageal varices; IGV: Isolated gastric varices; GOV: Gastro-oesophageal varices; IVCP: Inferior vena cava pressure; PVP: Portal vein pressure; GVP: Gastric varices pressure; HVPG: Hepatic venous pressure gradient; PPG: Portal pressure gradient; GVPG: Gastric varices pressure gradient.

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Citation: Wei W, Xue M, Xu LY. Gastric variceal pressure gradient in patients with large spontaneous shunts: A novel approach to local hemodynamic assessment. World J Gastroenterol 2026; 32(41): 121668
URL: https://www.wjgnet.com/1007-9327/full/v32/i41/121668.htm
DOI: https://dx.doi.org/10.3748/wjg.121668

Wei W, Xue M, Xu LY. Gastric variceal pressure gradient in patients with large spontaneous shunts: A novel approach to local hemodynamic assessment. World J Gastroenterol 2026; 32(41): 121668 [DOI: 10.3748/wjg.121668]

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