Chandigarh: PGIMER develops cost-effective procedure to treat cirrhosis complications

The department of hepatology at the Postgraduate Institute of Medical Education and Research has developed a cost effective method to treat complications linked with liver cirrhosis.
The procedure will help treat gastric varices (enlarged veins in the stomach) and hepatic encephalopathy (brain dysfunction due to liver disease).
Developed by Dr Sahaj Rathi and his team, this innovative technique called endoscopic ultrasound-guided transgastric shunt obliteration (ETSO) offers a promising therapeutic option.
Cirrhosis patients sometimes develop shunts, a hole or a small passage that allows movement of fluid from one part of the body to another, which can cause symptoms like brain fog and vomiting blood from swollen veins in the stomach. Up until now, these shunts were usually treated using a procedure called balloon-occluded retrograde transvenous obliteration (BTRO) done by special X-ray techniques. However, not all patients could afford or access this treatment due to monetary or technical reasons.
The new method will treat bleeding stomach veins (gastric varices) using a procedure called endoscopic ultrasound (EUS) by finding the bleeding vessels and blocking them using a special glue and coils.
One of the notable advantages of this technique is its significantly reduced cost and shorter procedure time. Additionally, this procedure can be performed in stages, which is particularly advantageous for patients with compromised liver function.
To demonstrate the effectiveness of this technique, it was presented at the Digestive Disease Week congress in San Diego, USA, in 2022. Following that, the team published their findings in the American Journal of Gastroenterology, detailing their experience with seven cases.
“So far, we have successfully treated over 12 cases of hepatic encephalopathy and more than 20 cases of gastric varices using this method,” stated PGI spokesperson.