Effect of transjugular intrahepatic portosystemic shunt formation on portal hypertensive gastropathy and gastric circulation

Citation
S. Mezawa et al., Effect of transjugular intrahepatic portosystemic shunt formation on portal hypertensive gastropathy and gastric circulation, AM J GASTRO, 96(4), 2001, pp. 1155-1159
Citations number
34
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
AMERICAN JOURNAL OF GASTROENTEROLOGY
ISSN journal
0002-9270 → ACNP
Volume
96
Issue
4
Year of publication
2001
Pages
1155 - 1159
Database
ISI
SICI code
0002-9270(200104)96:4<1155:EOTIPS>2.0.ZU;2-K
Abstract
OBJECTIVES: The aim of this study was to investigate the effect of a transj ugular intrahepatic portosystemic shunt (TIPS) on portal hypertensive gastr opathy (PHG) and gastric hemodynamics. METHODS: A total of 16 patients with cirrhosis and portal hypertensive gast ropathy were prospectively studied. Of these, 12 patients underwent TIPS fo r esophageal varices and four for refractory ascites. Gastric mucosal blood flow (GMBF) was assessed by laser Doppler flowmeter, and total blood flow (TBF) in submucosa and mucosa by near-infrared endoscopy. Portal venous pre ssure was obtained by a transducer during the TIPS procedure. The severity of portal hypertensive gastropathy was classified as none, mild, or severe. The examinations were performed before and 2 wk after the procedure. RESULTS: TIPS significantly reduced portal venous pressure. PHG improved in all four patients with severe PHG and in five of 12 patients with mild PHG after treatment. Gastric mucosal blood flow increased from 49.0 to 55.6 ml /min/100 g after TIPS. In contrast, TBF decreased from 0.35/s to 0.27/s aft er treatment. Liver function tests showed no significant changes before and after the procedure. CONCLUSIONS: It is considered that TIPS may have a beneficial effect on PHG at least for a short time. The mechanism by which PHG improves may be clos ely related to the improvement of the injured gastric perfusion in cirrhoti c patients with PHG. (Am J Gastroenterol 2001:96: 1155-1159. (C) 2001 by Am . Coll. of Gastroenterology).