EUS Guided Portal-systemic Pressure Gradient Measurement to Predict Treatment Response and Outcomes of Varices to Endoscopic Variceal Ligation in Patients With Chronic Hepatitis.

Launched by CHINESE UNIVERSITY OF HONG KONG · Oct 24, 2022

Keywords

ClinConnect Summary

This clinical trial is investigating a new method called EUS-PPGM, which stands for Endoscopic Ultrasound-Guided Portal-Systemic Pressure Gradient Measurement. The goal is to see if this method can help predict how well patients with chronic hepatitis and esophageal varices—swollen veins in the esophagus—respond to a treatment called endoscopic variceal ligation (EVL). EVL is a procedure used to tie off these varices to prevent bleeding. The researchers believe that if the EUS-PPGM reading is high after three months, it may indicate that the patient has varices that will need treatment when checked again in a year.

To participate in this study, individuals must be between 18 and 75 years old and have chronic hepatitis-related cirrhosis with esophageal varices that have been treated with EVL. Participants will undergo evaluations to measure their pressure levels and will be monitored over time to see how they respond to the treatment. It’s important to note that certain medical conditions may prevent someone from joining, such as severe liver disease or specific anatomical issues. This study is currently recruiting participants, and it could provide valuable information for improving care for patients with chronic liver disease.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age between 18 to 75 years old
• • Informed consent available
• • Suffering from chronic hepatitis induced cirrhosis
• • Suffering from oesophageal varices and received EVL as a result of
• • 1. Primary variceal prophylaxis during a variceal surveillance program on oesophagogastroduodenoscopy (OGD) or
• • 2. Secondary variceal prophylaxis after EVL in patients with active oesophageal variceal bleeding
• • Or bleeding gastric varices that have received endoscopic canoacrylate injection
• Exclusion Criteria:
• • Medical Child-Pugh Class C Uncorrected platelet count \<50,000 INR \> 1.5 (natural) History of hepatic encephalopathy Current or history of hepatocellular carcinoma
• • Anatomical Main portal vein thrombosis Anatomic alterations of the hepatic vasculature that prevent access to the portal vein or intrahepatic portion of the hepatic veins (identified at screening and/or during the endoscopic procedure).
• • Previous history of spontaneous bacterial peritonitis within the previous three months Portopulmonary hypertension Cardiac decompensation
• • - Endoscopically Confirmed Exclusion Criteria Presence of ascites in the path of the needle that prevents apposition of the gastrointestinal tract and liver.
• • Presence of gastric or duodenal ulcers, dieulafoy's lesion or cancers