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Corresponding Author

Ayman Ahmed Shawky Said

Document Type

Original Article

Abstract

Background: Portal hypertensive gastropathy (PHG) refers to the visible alterations in the stomach that occur due to the dilatation of blood vessels in the mucosal submucosal layers, as observed during an upper endoscopy.

Aim: To compare Endoscopic band ligation (EBL), Argon plasma coagulation (APC), and combined (EBL) & (APC) in the management of severe PHG associated with post-hepatitis liver cirrhosis.

Patients and methods: This research performed on 108 cirrhotic individuals had overt or occult bleeding from severe PHG attending the Hepatology, Gastroenterology & infectious diseases Department, Al Azhar university hospitals, from June 2021till June 2022. individuals were separated into three groups: Group I: 35 patients underwent APC sessions, Group II: 37 patients underwent (EBL) only, and Group III: 36 patients underwent combined sessions of APC and EBL.

Results: There was statistically significant variance among the examined groups concerning the improvement of post-treatment hemoglobin level, with no statistically significant variance regarding post-treatment hospitalization, transfusion, and incidence of endoscopic complications. Regarding the pre-and post-treatment hemoglobin level improvement in overt bleeding patients, There was a statistically significant variance, while in occult bleeding individuals, there was no statistically significant variance.

Conclusion: APC, EBL, and combined therapies are all effective procedures in managing severe PHG with no major endoscopic complications. In overt bleeding patients: Combined therapy of APC and EBL showed more superiority over APC and EBL alone. In occult bleeding patients: All procedures are effective, with no superiority of any procedure over the others.

Keywords

PHG, APC, EBL

Subject Area

Endemic diseases and tropical medicine

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