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Endoscopic ultrasound guided portal pressure measurement to predict the outcome of liver resectio

Not Applicable
Conditions
Portal Hypertension
Liver Cirrhosis
Oral and Gastrointestinal - Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
Registration Number
ACTRN12621000464864
Lead Sponsor
Royal Adelaide Hospital
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot yet recruiting
Sex
All
Target Recruitment
40
Inclusion Criteria

1) Patients (with or without cirrhosis) who are recommended for liver resection or liver transplant
2) Patients with cirrhosis who are recommended to undergo abdominal surgery

Exclusion Criteria

1) International Normalised Ratio (INR) > 1.6
2) Significant ascites
3) Child-Pugh C severity of cirrhosis
4) Presence of large gastric varices or periportal collateral vessels that prevent EUS approach to the hepatic and/or portal vasculature

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
To compare the efficacy between EUS-PPGM and TJ-HVPG measurements. The accuracy of the EUS-PPG in predicting Post hepatectomy liver failure will be assessed by measuring the area under the receiver operating characteristics (AUROC) curve, and differences between AUROCs will be compared using the Hanley-McNeil method. Post-operative liver dysfunction is define as:<br>(i) serum bilirubin level > 5 mg/dL (> 85.5 umol/L) on or after postoperative day 5; (ii) coagulopathy (INR > 2.0 associated with haemorrhagic complications requiring transfusion); (iii) hepatic encephalopathy; and (iv) abdominal ascites (drainage volumes more than 500 mL/day after day 3).<br>[Procedural details will be collected immediately after procedure, and within 24 hours and 7 days post-procedure.]
Secondary Outcome Measures
NameTimeMethod
To compare the safety between EUS-PPGM and TJ hepatic venous pressure gradient measurements. This will include data on intraprocedural or postprocedural complications such as bleeding, perforation, pain, infection, need for transfusion, and length of hospital stay. The data will be collected from electronic medical records and hospital records. [Details will be collected immediately after procedure, 24 hours post procedure and/or following discharge from hospital. <br>];To compare cost differences between EUS PPGM and TJ HVPG technique approaches. Costs will be assessed via hospital medical records, and by calculating the differences between the resources used.[This will be assessed within 48 hours following procedure.];90-day mortality of participant. [This will be assessed at 90 day follow up with investigator following their procedure.]
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