Title: Study of Portal Hemodynamic Changes Using Doppler Ultrasound in Egyptian Cirrhotic Patients with Oesophageal Varices Treated By Band Ligation with or Without Beta Blockers
Portal Hemodynamics In Egyptian Cirrhotics
Authors: Mohamed Tamer Afifi, Ezzat Ali Ahmed, Ayman Mohamed Shamseya, Mohamed Mahmoud Elshafei, Essam Eldin Saeed Bedewy and Amr Ahmed Mahmoud Dorra
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.49
Background and aims: Egypt has the largest burden of hepatitis C infection & liver cirrhosis worldwide. Sixty percent of cirrhotic patients develop esophageal varices and thirty percent suffer variceal hemorrhage. Studying portal hemodynamics using duplex Doppler is non-invasive, reliable and relatively cheap method for evaluating portal hemodynamic changes in cirrhotic patients; also it can be used in studying the effect and prognosis of different drugs used to reduce portal hypertension. Where as Baveno Consensus conference recommends β-blockers, banding ligation or both; the experts add that combined therapy is probably the best. Aim Of The Work: was to study portal hemodynamics in cirrhotic patients with esophageal varices admitted for band ligation with and without the administration of propranolol. Patients And Methods: 50 patients eligible for the study (cirrhosis, esophageal varices and no contraindications for propranolol), were randomized into two groups: Group I: 25 patients on oral propranolol (non-selective β-blocker) combined with endoscopic variceal band ligation. Group II: 25 patients on endoscopic variceal band ligation alone without oral propranolol. Results: As regards to Portal vein diameter (PVD), Portal vein flow velocity (VEL), and Congestion index (CI), there was no statistically significant difference between the two groups before the start of the treatment. After 6 months of treatment, there was statistically significant difference between the two studied groups as regards to PVD & VEL, while non-statistically significant difference for CI. Conclusions: both band ligation and propranolol reduced portal hemodynamic parameters, but patients on combination of both showed better results. Key-words: portal hypertension, hepatitis, sclerotherapy 1. 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