Effects on Gastric Circulation of Treatment for Portal Hypertension in Cirrhosis

We evaluated the gastric circulatory effects ofthe type of treatment administered for portalhypertension. Of 14 patients with cirrhosis, sevenreceived a transjugular intrahepatic portosystemic shunt (TIPS; group T) and seven received percutaneoustranshepatic portographic embolization (PTPE; group P).Patients were evaluated over the course of one year.After treatment, portal venous pressure wassignificantly reduced from 39 ± 6 cmH2O to 32 ± 5 (P < 0.001) in groupT and was significantly elevated from 29 ± 10 to33 ± 8 (P < 0.05) in group P. The portal flowvelocity (Vmean) was significantly higher in group T vs group P (P < 0.0001).The congestion index was significantly lower in group Tthan in group P (P < 0.0001). The gastric mucosalblood flow was increased in group T but was unchanged in group P. Esophageal varices showed someimprovement in both groups, but the portal hypertensivegastropathy was improved only in group T. These findingshelp to explain the differing effects on the gastric circulation related to the type of treatmentused for portal hypertension.