Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2490-2499
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2490
Hepatic venous pressure gradient: Inaccurately estimates portal venous pressure gradient in alcoholic cirrhosis and portal hypertension
Dan Zhang, Tao Wang, Zhen-Dong Yue, Lei Wang, Zhen-Hua Fan, Yi-Fan Wu, Fu-Quan Liu
Dan Zhang, Zhen-Dong Yue, Lei Wang, Zhen-Hua Fan, Yi-Fan Wu, Fu-Quan Liu, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Tao Wang, Department of Interventional Therapy, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264099, Shandong Province, China
Author contributions: Liu FQ designed the research; Wang T, Yue ZD, Wang L, Fan ZH and Wu YF performed the research; Zhang D analyzed the data and wrote the paper; Liu FQ reviewed and revised the manuscript; All authors have read and approved the final manuscript.
Supported by the Capital Health Research and Development of Special, No. 2018-1-2081; National Natural Science Foundation of China, No. 81871461.
Institutional review board statement: The study was reviewed and approved by the Beijing Shijitan Hospital, Capital Medical University Institutional Review Board [2018(01)].
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at liufuquan@ccmu.edu.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Quan Liu, MM, Chief Doctor, Doctor, Professor, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian Street, Haidian District, Beijing 100038, China. liufuquan@ccmu.edu.cn
Received: August 13, 2023
Peer-review started: August 13, 2023
First decision: September 20, 2023
Revised: October 3, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 27, 2023
ARTICLE HIGHLIGHTS
Research background

The hepatic venous pressure gradient (HVPG), rather than the portal venous pressure gradient (PPG), is regarded as the gold standard for diagnosing portal hypertension (PHT).

Research motivation

The relationship between HVPG and PPG is controversial and lacks substantial research to prove it.

Research objectives

This study aimed to classify the correlation between HVPG and PPG in patients with alcoholic cirrhosis and PHT.

Research methods

This retrospective analysis of various pressures during transjugular intrahepatic portosystemic shunt (TIPS) procedures explored the relationship between HVPG and PPG in patients with alcoholic cirrhosis and PHT.

Research results

The correlation coefficient (r) and determination coefficient (R2) between HVPG and PPG were 0.201 and 0.040, respectively (P = 0.020). Hepatic collaterals were identified in 26 patients with balloon occlusion hepatic venography (19.4%), while the average PPG was significantly higher than the average HVPG (25.94 ± 7.42 mmHg vs 9.86 ± 7.44 mmHg; P < 0.001). The collateral versus no collateral branches groups had 3 (11.54%) and 44 (40.74%) patients, respectively, with differences of < 5 mmHg between HVPG and PPG.

Research conclusions

HVPG cannot accurately represent PPG in most patients. The formation of hepatic collaterals is a vital reason for the strong underestimation of HVPG.

Research perspectives

Based on different pressures during TIPS procedures, the correlation and differences between HVPG and PPG of patients were explored.