Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

Table 3 Effects of variceal ligation on frequency of portal hypertensive gastropathy

Ref.	No. of patients and etiology	Study type	PHG rate before variceal ligation	PHG aggravation after variceal ligation	P value of pre vs post EVL
Hou et al[73]	90 patients with cirrhosis and recent variceal bleeding, 46 patients underwent EVL	Randomized, controlled trial	No PHG-4, mild PHG-33, severe-PHG-9	At eradication: 17/37; 17/37 (45.9%) in EVL; at 3 mo: 17/30 (56.7%); at 6 mo 18/29 (62.1%)	P > 0.05
Elnaser et al[80]	125 patients with upper GI bleeding undergoing variceal ligation, followed for mean of 31 mo	Retrospective study	22/125 (17.6%)	50/125 (50%)	P < 0.05
Yüksel et al[41]	114 patients with cirrhosis and portal hypertension undergoing EVL in 85 patients	Retrospective study	27/85 (31.8%) none; 28/85 (32.9%) mild; 30/85 (35.3%) severe	14/85 (16.5%) none; 30/85 (35.3%) mild; 41/85 (48.2%) severe	P < 0.05
Lo et al[81]	77 patients with bleeding from EV underwent variceal ligation and were randomized to receive propranolol (37/77) or control (40/77); patients with severe PHG prior to treatment excluded from the study	Prospective, randomized, controlled trial	Control group: 7/40 (17%); propranolol group: 8/37 (22%)	At variceal ligation: Control group: 67% (does not state number); Propranolol group: 31% (number not stated); 6 mo after treatment: Control group: 85% (number not stated) propranolol group: 48% (number not stated)	Pre vs post ligation, both groups; P < 0.05; frequency of PHG significantly higher in control group post ligation when compared to propranolol group; P = 0.002
de la Peña et al[82]	93 patients with history of variceal hemorrhage and cirrhosis, randomized to receive either EVS (46/88) or EVL (42/88); 5 patients excluded due to diagnosis of hepatoma, non-cirrhotic portal hypertension or portal vein thrombosis	Randomized, prospective study	Not reported	PHG significantly worsened in 23 patients, including 17 patients undergoing EVL	P < 0.01

PHG: Portal hypertensive gastropathy; EVL: Endoscopic variceal ligation; EVS: Endoscopic variceal sclerotherapy.