Gallbladder wall thickening as a non-invasive screening parameter for esophageal varices compared to upper GI endoscopy

Abstract

Our results showed some parameters were independently associated with EV, including Platelet count, AFP, Liver span, AND GBWT. On assessment of GBWT as screening tool, IT showed good results with an AUROC of 0.81 with a sensitivity, specificity, PPV, and NPV of 76, 76,76, and 76 respectively. On assessment of various parameters for association with EV it was found that AST, Albumin as well as GBWT, and PV diameter were statistically significant.

Gastroesophageal variceal hemorrhage, a major complication of portal hypertension resulting from cirrhosis, accounts for 10 to 30 percent of all cases of bleeding from the upper gastrointestinal tract. Variceal hemorrhage occurs in 25 to 35 percent of patients with cirrhosis and accounts for 80 to 90 percent of bleeding episodes in these patients. Variceal hemorrhage is associated with more substantial morbidity and mortality than other causes of gastrointestinal bleeding, as well as with higher hospital costs. Inspite the fact that Upper GI endoscopy procedure is an invasive test has pitfalls, present higher risk in patients with cirrhosis, as well as higher cost and less availability and convenience to patients, it remains to be the Gold standard For variceal screening. Many noninvasive screening tests was being assessed in the last 20 years, only a very few that has been efficiently validated and accepted for general clinical practice. In liver cirrhosis, gallbladder wall thickening is frequently observed by Radiologists and it is often reported in association with portal hypertension. In our study our aim was the evaluation of the effectiveness of ultrasonographic measurement of Gallbladder wall thickening as a noninvasive screening parameter for EVs compared to upper GI endoscopy as the standard screening method.