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Combined measurements of serum bile acid level and splenic volume may be useful to noninvasively assess portal venous pressure.
MedLine Citation:
PMID:  22569764     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We aimed to identify a noninvasive predictor of portal venous pressure (PVP). METHODS: We directly measured the PVP in 40 consecutive patients who underwent direct percutaneous transhepatic portal vein puncture as part of the therapeutic management for liver diseases, and we evaluated the association of the PVP with noninvasive clinical parameters. The backgrounds of the liver were normal in 13 patients, chronic hepatitis in 17, and liver cirrhosis in ten. RESULTS: The mean PVP was 202 ± 114 mmH(2)O. In a multivariate linear regression analysis, the serum bile acid level and splenic volume showed independent positive correlations with the PVP (P < 0.001 and 0.002, respectively). The formula for estimating PVP was identified as follows: PVP (mmH(2)O) = serum bile acid (μmol/L) × 2.593 + splenic volume (cm(3)) × 0.416 + 65.929 (R (2) = 0.698). In a receiver operating characteristic (ROC) analysis, the AUC values of serum bile acid and splenic volume at a PVP of 200 mmH(2)O were 0.909 and 0.758, respectively. However, the AUC values of serum bile acid and splenic volume at a PVP of 250 mmH(2)O were 0.792 and 0.926, respectively, suggesting that the serum bile acid level and splenic volume are sensitive predictors of early and advanced portal hypertension, respectively. CONCLUSIONS: Combined measurements of the serum bile acid level and splenic volume may be useful to noninvasively assess the PVP prior to further invasive procedures.
Authors:
Hiromitsu Hayashi; Toru Beppu; Hirohisa Okabe; Hidetoshi Nitta; Katsunori Imai; Koichi Doi; Akira Chikamoto; Hideo Baba
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-9
Journal Detail:
Title:  Journal of gastroenterology     Volume:  -     ISSN:  1435-5922     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
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