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Effects of endoscopic variceal ligation on portal hypertensive gastropathy and gastric mucosal blood flow.
Am J Gastroenterol. 1998 Jan; 93(1):71-4.AJ

Abstract

OBJECTIVE

Portal hypertensive gastropathy (PHG) has been recognized recently as a potential cause of upper gastrointestinal tract bleeding and is associated with a change in gastric hemodynamic indices in cirrhotic patients with portal hypertension. Endoscopic variceal ligation (EVL) is the treatment of choice for esophageal varices. We investigated the early effect of EVL on PHG and gastric mucosal blood flow (GMBF).

METHODS

We examined 35 cirrhotic patients who were treated by EVL. PHG was evaluated endoscopically and GMBF was measured by laser Doppler flowmetry before and 1 or 2 wk after EVL.

RESULTS

After EVL, only two patients (5.7%) developed severe PHG, 6 (17.1%) developed mild PHG, and 27 (77.1%) showed no change in endoscopic appearance of PHG. In those patients who developed PHG, EVL significantly decreased GMBF at the corpus (p < .05). However, no significant changes of GMBF at the corpus were noted after EVL in those patients who had no worsening of endoscopic features. EVL had no effect on GMBF at the antrum in any patients.

CONCLUSIONS

Endoscopic variceal ligation is safe and does not lead, at least within 1-2 wk, to worsening of gastropathy in most cases. Our finding that gastropathy developed in the presence of reduced GMBF may suggest that PHG develops as a result of congestion caused by blockade of gastric blood drainage rather than by hyperemia.

Authors+Show Affiliations

Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

9448178

Citation

Yoshikawa, I, et al. "Effects of Endoscopic Variceal Ligation On Portal Hypertensive Gastropathy and Gastric Mucosal Blood Flow." The American Journal of Gastroenterology, vol. 93, no. 1, 1998, pp. 71-4.
Yoshikawa I, Murata I, Nakano S, et al. Effects of endoscopic variceal ligation on portal hypertensive gastropathy and gastric mucosal blood flow. Am J Gastroenterol. 1998;93(1):71-4.
Yoshikawa, I., Murata, I., Nakano, S., & Otsuki, M. (1998). Effects of endoscopic variceal ligation on portal hypertensive gastropathy and gastric mucosal blood flow. The American Journal of Gastroenterology, 93(1), 71-4.
Yoshikawa I, et al. Effects of Endoscopic Variceal Ligation On Portal Hypertensive Gastropathy and Gastric Mucosal Blood Flow. Am J Gastroenterol. 1998;93(1):71-4. PubMed PMID: 9448178.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of endoscopic variceal ligation on portal hypertensive gastropathy and gastric mucosal blood flow. AU - Yoshikawa,I, AU - Murata,I, AU - Nakano,S, AU - Otsuki,M, PY - 1998/2/3/pubmed PY - 1998/2/3/medline PY - 1998/2/3/entrez SP - 71 EP - 4 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 93 IS - 1 N2 - OBJECTIVE: Portal hypertensive gastropathy (PHG) has been recognized recently as a potential cause of upper gastrointestinal tract bleeding and is associated with a change in gastric hemodynamic indices in cirrhotic patients with portal hypertension. Endoscopic variceal ligation (EVL) is the treatment of choice for esophageal varices. We investigated the early effect of EVL on PHG and gastric mucosal blood flow (GMBF). METHODS: We examined 35 cirrhotic patients who were treated by EVL. PHG was evaluated endoscopically and GMBF was measured by laser Doppler flowmetry before and 1 or 2 wk after EVL. RESULTS: After EVL, only two patients (5.7%) developed severe PHG, 6 (17.1%) developed mild PHG, and 27 (77.1%) showed no change in endoscopic appearance of PHG. In those patients who developed PHG, EVL significantly decreased GMBF at the corpus (p < .05). However, no significant changes of GMBF at the corpus were noted after EVL in those patients who had no worsening of endoscopic features. EVL had no effect on GMBF at the antrum in any patients. CONCLUSIONS: Endoscopic variceal ligation is safe and does not lead, at least within 1-2 wk, to worsening of gastropathy in most cases. Our finding that gastropathy developed in the presence of reduced GMBF may suggest that PHG develops as a result of congestion caused by blockade of gastric blood drainage rather than by hyperemia. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9448178/Effects_of_endoscopic_variceal_ligation_on_portal_hypertensive_gastropathy_and_gastric_mucosal_blood_flow_ L2 - https://Insights.ovid.com/pubmed?pmid=9448178 DB - PRIME DP - Unbound Medicine ER -