Post-TIPS Change of Esophagogastric Variceal Size on Endoscopy

Kim, Yong Joo; Shin, Hyun Woong; Park, Aw Hwan; Kang, Duk Sik

Abstract

PURPOSE: To evaluate the relationship between endoscopic change in esophagogastric varices and post transjugular intrahepatic portosystemic shunt (TIPS) portal pressure reduction, and to study any difference in post-TIPS endoscopic change between esophageal and gastric varices. MATERIALS AND METHODS: Sixty four patients who had undergone pre- and post- TIPS endoscopic examination were analysed. They were divided into two groups, Group 1 (n = 40) and Group 2 (n = 24), according to whether they had not or had, respectively, undergone post-TIPS residual variceal embolization. The varices were classified as either esophageal (n = 54) or gastric (n = 60). Post TIPS endoscopic change was evaluated as Grade 1 (complete disappearance), Grade 2 (partial disappearance), or Grade 3 (no change). Mean pressure reduction between the pre and post TIPS portosystemic pressure gradient was checked, and statistical correlation between mean portal pressure reduction and endoscopic change in Group 1 and Group 2 was evaluated using the ANOVA test. By means of the x2 test, post-TIPS endoscopic change between esophageal and gastric varices was also evaluated. RESULTS: In Group I, a significant statistical relationship was found between endoscopic change and mean portal pressure reduction (p<0.001), but in Group 2, no such relationship was found (p>0.05). No significant statistical difference was found between endoscopic change in esophageal and in gastric varices (p> 0 . 0 5 ). CONCLUSION: In patients who had not undergone post-TIPS residual variceal embolization, endoscopicf change in gastroesophageal varices correlated significantly with post-TIPS portal pressure reduction. With regard to post-TIPS endoscopic change, these was no significant difference between esophageal and gastric varices.