Journals / Turkish Journal of Gastroenterology / 2017 / Cilt: 28 - Sayı: 3

Non-invasive diagnosis of esophageal varices after Baveno VI

Pages
159–165
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Finally, we will mention some potential caveats and suggest some areas for future research.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:A major complication of portal hypertension in patients with cirrhosis is the development of esophageal varices with the associated risk of variceal bleeding.
📊
Key Findings & Data:Hence, the Baveno consensus on portal hypertension in its first five editions had recommended surveillance with periodic upper endoscopies in these patients to identify in a timely fashion the development of esophageal varices and initiate a primary prophylaxis strategy in those at a high risk of bleeding.
💡
Conclusion & Impact:Finally, we will mention some potential caveats and suggest some areas for future research.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

A major complication of portal hypertension in patients with cirrhosis is the development of esophageal varices with the associated risk of variceal bleeding. Hence, the Baveno consensus on portal hypertension in its first five editions had recommended surveillance with periodic upper endoscopies in these patients to identify in a timely fashion the development of esophageal varices and initiate a primary prophylaxis strategy in those at a high risk of bleeding. For the first time, the Sixth Baveno Consensus on Portal Hypertension (Baveno VI) recommended using non-invasive tools to rule out the presence of varices with a high risk of bleeding. According to Baveno VI, surveillance endoscopy is not necessary for patients with "compensated advanced chronic liver disease" (cACLD) who have normal platelets (>150×109/L) and a liver stiffness measure (LSM) <20 kPa. In this review, we will briefly describe the currently available non-invasive methods to predict the presence of varices, such as serum tests, imaging, and elastography. We will also discuss the rationale that led to Baveno VI recommendation and describe the studies that have validated Baveno VI criteria after its publication. Finally, we will mention some potential caveats and suggest some areas for future research.

🔖

Cite This Article

ABRALDES, J. G., MOCTEZUMA-VELÁZQUEZ, C. (2017). Non-invasive diagnosis of esophageal varices after Baveno VI. Turkish Journal of Gastroenterology, Cilt: 28 - Sayı: 3, 159–165. https://ajindex.com/articles/410694

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. de Franchis R, Baveno VIF. Expanding consensus in portal hyper- tension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol 2015
  2. [CrossRef ] Garcia-Tsao G, Abraldes J, Berzigotti A, Bosch J. Portal hyper- tensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Associa- tion for the study of liver diseases. Hepatology 2017
  3. [CrossRef ] D'Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognos- tic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006
  4. [CrossRef ] D'Amico G, Pasta L, Morabito A, et al. Competing risks and prog- nostic stages of cirrhosis: a 25-year inception cohort study of 494 patients. Aliment Pharmacol Ther 2014
  5. [CrossRef ] Abraldes J. The value of non-invasive tests for risk stratification in patients with compensated cirrhosis. Mamara Medical Journal 2016
  6. [CrossRef ] Hernandez-Gea V, Berzigotti A. Clinical evaluation and prognosis. Dig Dis 2015
  7. [CrossRef ] Ripoll C, Groszmann R, Garcia-Tsao G, et al. Hepatic venous pres- sure gradient predicts clinical decompensation in patients with compensated cirrhosis. Gastroenterology 2007
  8. [CrossRef ] Bruno S, Zuin M, Crosignani A, et al. Predicting mortality risk in patients with compensated HCV-induced cirrhosis: a long- term prospective study. Am J Gastroenterol 2009
  9. [CrossRef ] Groszmann RJ, Garcia-Tsao G, Bosch J, et al. Beta-blockers to pre- vent gastroesophageal varices in patients with cirrhosis. N Engl J Med 2005
  10. [CrossRef ] Merli M, Nicolini G, Angeloni S, et al. Incidence and natural history of small esophageal varices in cirrhotic patients. J Hepatol 2003
  11. [CrossRef ] Garcia-Tsao G. Preventing the development of varices in cirrhosis. J Clin Gastroenterol 2007
  12. 41(Suppl 3): S300-S4. [CrossRef ] Qi XS, Bao YX, Bai M, Xu WD, Dai JN, Guo XZ. Nonselective beta- blockers in cirrhotic patients with no or small varices: A meta- analysis. World J Gastroenterol 2015
  13. [CrossRef ] Di Pascoli L, Buja A, Bolognesi M, et al. Cost-effectiveness analysis of beta-blockers vs endoscopic surveillance in patients with cir- rhosis and small varices. World J Gastroenterol 2014
  14. 10464-9. [CrossRef ] Bhardwaj A, Kedarisetty CK, Vashishtha C, et al. Carvedilol delays the progression of small oesoph