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Assessment of short‐term prognosis after variceal bleeding in patients with alcoholic cirrhosis by early measurement of portohepatic gradient
Author(s) -
Vinel J. P.,
Cassigneul J.,
Levade M.,
Voigt J. J.,
Pascal J. P.
Publication year - 1986
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840060122
Subject(s) - medicine , esophageal varices , cirrhosis , portal hypertension , portal venous pressure , varices , gastroenterology , alcoholic liver disease , surgery
Seventy‐two consecutively admitted patients with biopsy‐proven alcoholic cirrhosis and a bleeding episode endoscopically proven to originate from ruptured esophageal varices were studied. Hemodynamic assessment was performedwithin 48 hr of admission using the transjugular approach. Mean portal pressure was found to be significantly greater in the group of patients who died than in those who survived for 1 week, 2 weeks or 1 month after admission. We conclude that: The portohepatic pressure gradient and portal pressure have short‐term prognostic value in patients with alcoholic cirrhosis bleeding from ruptured esophageal varices. Owing to a high early mortality, any delay between the occurrence of a bleeding episode and the measurement of portal pressure appears to select a sample of survivorswith a significantly lower mean level of portal pressure than in those measured earlier. When evaluating portal pressure, the time of study is one of the most important variables which may affect the conclusions.