[Analysis of portal vein thrombosis formation and risk factors after endoscopic treatment in patients with esophagogastric varices in liver cirrhosis].

Abstract

Objective: To analyze the incidence rate, compare the differences, and assess the risk factors for portal vein thrombosis (PVT) formation after different endoscopic treatment methods in patients with esophagogastric varices in cirrhosis. Methods: The laboratory, imaging, and endoscopic treatment methods data for 289 patients with esophagogastric varices in liver cirrhosis who initially received endoscopic treatment at the Endoscopy Center of You'an Hospital, affiliated with Capital Medical University, from January 2020 to December 2022, were retrospectively included. The incidence rate of PVT within 1 year after systematic standardized endoscopic treatment was statistically analyzed. Univariate and multivariate logistic regression analyses were used to screen the risk factors for PVT formation after endoscopic treatment. The t-test or rank-sum test was used to compare continuous data between the two groups. The χ² test was used for categorical data. Results: The incidence rate of portal vein thrombosis (PVT) within 1 year was 20.76% (60/289) among 289 patients with esophagogastric varices in cirrhosis who underwent standard endoscopic treatment. The PVT incidence rate was 22.81% (13/57) in patients who used sclerotherapy alone and 15.22% (7/46) in patients who used ligation rings alone, with no statistically significant difference in the PVT incidence among different endoscopic treatment methods (χ²=2.354, P>0.05). Univariate analysis showed statistically significant differences in preoperative platelet count, spleen thickness, spleen long diameter, model for end-stage liver disease score, ascites, and smoking between the PVT group and the non-PVT group (P<0.05). Multivariate logistic regression analysis showed that preoperative platelet count [odds ratio (OR) = 0.988, 95% (confidence interval, CI): 0.979-0.998, P = 0.018], splenic ultrasound thickness (OR = 1.051, 95%CI: 1.003-1.101, P = 0.038), massive ascites (OR = 14.153, 95%CI: 2.517-79.577, P = 0.003), and smoking (OR = 2.537, 95%CI: 1.267-5.076, P = 0.009) were independent risk factors for PVT formation. Conclusion: The incidence rate of PVT is similar to the current known annual incidence rate of PVT following endoscopic treatment in patients with esophagogastric varices in liver cirrhosis, and different endoscopic treatment methods have no significant effect on PVT formation. Preoperative platelet count, spleen thickness, massive ascites, and smoking are risk factors for PVT formation.