Managing liver cirrhotic complications: Overview of esophageal and gastric varices.
Managing liver cirrhotic complications: Overview of esophageal and gastric varices.
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DOI：
10.3350/cmh.2020.0022
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发表时间：
2020-10
影响因子：
8.9
通讯作者：
Gani RA
中科院分区：
文献类型：
--
作者：
Lesmana CRA;Raharjo M;Gani RA
在临床实践中管理肝硬化仍然是一个具有挑战性的问题，因为它的进展与严重的并发症有关，例如可能增加死亡率的静脉曲张出血。门静脉高压症（PH）是肝硬化并发症发生发展的关键。门静脉压力高于10 mmHg，称为临床显著的门静脉高压，与静脉曲张的形成有关;同时，门静脉压力高于12 mmHg与静脉曲张出血有关。肝静脉压力梯度测量和食管胃镜检查仍然是评估门静脉压力和检测静脉曲张的金标准。最近，非侵入性方法已被研究用于肝硬化患者门静脉压力和静脉曲张检测的评估。已经发表了各种指南，用于指导临床医生治疗食管胃静脉曲张，旨在预防静脉曲张、急性静脉曲张出血和静脉曲张再出血的发生。本文根据当前国际指南和印度尼西亚的真实的经验，对肝硬化患者PH和静脉曲张的发展及其管理进行了全面的综述。
Managing liver cirrhosis in clinical practice is still a challenging problem as its progression is associated with serious complications, such as variceal bleeding that may increase mortality. Portal hypertension (PH) is the main key for the development of liver cirrhosis complications. Portal pressure above 10 mmHg, termed as clinically significant portal hypertension, is associated with formation of varices; meanwhile, portal pressure above 12 mmHg is associated with variceal bleeding. Hepatic vein pressure gradient measurement and esophagogastroduodenoscopy remain the gold standard for assessing portal pressure and detecting varices. Recently, non-invasive methods have been studied for evaluation of portal pressure and varices detection in liver cirrhotic patients. Various guidelines have been published for clinicians’ guidance in the management of esophagogastric varices which aims to prevent development of varices, acute variceal bleeding, and variceal rebleeding. This writing provides a comprehensive review on development of PH and varices in liver cirrhosis patients and its management based on current international guidelines and real experience in Indonesia.
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