Yuko Sugimoto

Efficacy of combined balloon-occluded retrograde transvenous obliteration and simultaneous endoscopic injection sclerotherapy.

OBJECTIVE We evaluated the efficacy and safety of balloon-occluded retrograde transvenous obliteration (B-RTO) performed using absolute ethanol with iodized oil (ET+LPD) and simultaneous endoscopic injection sclerotherapy (EIS) with cyanoacrylate (CA) for gastric varices (GVs). METHODS A total of 16 patients with endoscopically proven high-risk GVs treated using combined B-RTO with ET+LPD and EIS with CA between January 2007 and July 2012 were enrolled. RESULTS Twelve cases included GVs involving both the cardia and fundus, two cases included fundal varices and two cases included cardiac varices. In terms of the form of GVs, 10 cases involved F2 lesions and six cases involved F3 lesions. The flow vein was the left gastric vein in 13 cases and the posterior gastric vein in three cases. The drainage route was a splenorenal shunt in all cases. The average dose of ET+LPD was 12.0 mL, while that of CA was 2.45 mL. All complications were transient, and no major complications occurred after the procedures. None of the patients experienced bleeding or recurrence of gastric varices after the combined B-RTO and EIS procedures during an average follow-up period of 38.3 months. CONCLUSION Combined B-RTO with ET+LPD and simultaneous EIS with CA is considered to be an effective and safe procedure for treating GVs.

Su1476 Efficacy of Combined Balloon-Occluded Retrograde Transvenous Obliteration With Ethanol and Endoscopic Injection Sclerotherapy for Gastric Varices

excluded. Several clinical, biological, ultrasonographic, with Doppler study, and endoscopic data were collected and used to calculate the APRI score (AST to platelets ratio index) and congestion index (CI) of the portal vein (calculated by dividing portal vein cross-sectional area by portal blood velocity). All statistical analysis was performed with SPSS v. 18.0 and a p value of less than 0,05 was considered statistically significant. The performance of the scores was evaluated by the area under the receiver operating characteristic curve (AUROC). Results: 36 patients were included, 64% males, with mean age 60±8,6 years. On On endoscopy, 12 patients (33%) had no EV, 14 patients (39%) had small EV and 10 patients (28%) had large EV. Portal vein diameter was higher in patients with EV than those without EV, while platelet count and portal blood velocity were lower, however with no statistical difference, (p>0,05). APRI score and CI were good predictors for the presence of EV (AUROC 0.74 and 0,635 respectively). The combination of the APRI score for liver fibrosis and CI as a surrogate of portal hypertension resulted in an even more powerful predictor of the presence of EV (AUROC 0,797) and the best cutoff value was 0,075 (sensitivity 79,2%, specificity 75%, positive predictive value 86,4% and negative predictive value 64,3). Conclusions: APRI score and CI of the portal vein are good noninvasive tests to predict esophageal varices. The combination of both models is even more powerful to be used as a method to select cirrhotic patients who need to undergo upper GI endoscopy.

Su1471 Noninvasive Evaluation of the Risk of Hepatocellular Carcinoma Oncogenesis in Chronic Hepatic Disease by Measuring Shear Wave Velocity

Partially Hydrolyzed Guar Gum (PHGG) Attenuates Nonalcoholic Steatohepatitis (NASH) in Mice Through the Gut-Liver Axis Kazuhiro Katada, Yuji Naito, Tomohisa Takagi, Katsura Mizushima, Yasuki Higashimura, Tetsuya Okayama, Naohisa Yoshida, Kazuhiro Kamada, Kazuhiko Uchiyama, Ishikawa Takeshi, Osamu Handa, Hideyuki Konishi, Nobuaki Yagi, Hiroshi Ichikawa, Zenta Yasukawa, Makoto Tokunaga, Tsutomu Okubo, Lekh R. Juneja, Yoshito Itoh