RELATIONSHIP BETWEEN PORTAL PRESSURE, ESOPHAGEAL-VARICES, AND VARICEAL BLEEDING ON THE BASIS OF THE STAGE AND CAUSE OF CIRRHOSIS

Background and Methods: Hepatic venous pressure gradient, esophageal v arices, and variceal bleeding were investigated in 957 patients with c irrhosis. The causes (alcoholic/virus) and stage (Child-Pugh's classif ication) of cirrhosis were also taken into account. Results: The preva lence of variceal bleeding was 35% in patients with large varices and 17% in those with small varices (P < 0.05). It was higher in patients with alcoholic cirrhosis (41% and 19%, respectively) than in those wit h viral cirrhosis (22% and 10%, respectively). In patients with alcoho lic cirrhosis the hepatic venous pressure gradient was higher in Child A and B patients with small or large varices than in those with no va rices; these differences were not found in Child C patients and in pat ients with viral cirrhosis. In all subgroups the pressure gradient was higher in Child C patients than in Child A patients. There was no sig nificant difference in the hepatic venous pressure gradient between pa tients with varices and previous variceal bleeding and those with no b leeding whatever the stage of cirrhosis. Conclusions: This study shows that the hepatic venous pressure gradient is associated with the stag e and causes of cirrhosis and the presence of varices. These factors s hould be taken into account in studies evaluating the hepatic venous p ressure gradient in heterogeneous groups of patients.