Color Doppler Ultrasonography Changes of Portal Circulation after Band Ligation of Esophageal Varices in Egyptian Patients with Chronic Liver Disease

Chronic liver disease (CLD) can result in portal hypertension (PH), the key event leading to formation of portosystemic collaterals including gastroesophageal varices (EVs). Esophagogastroduodenoscopy (EGD) is recommended as the first line investigation at the initial diagnosis. Doppler ultrasound is alternative, non-invasive parameter for surveillance of EVs. Aim of the work: was to study the Color Doppler Ultrasound changes of portal circulation in Egyptian patients with chronic liver disease after band ligation and its role in early detection of newly developed Varices. METHODS: This is prospective study conducted on 30 patients with (CLD) subjected to band ligation of (EVs), and 15 subjects with despepsia were chosen endoscopically without varices and sonographically free as a control group. upper endoscopy, CBC, liver and kidney function tests, Histopathological examination of upper endoscopic biopsies, abdominal and Color Doppler ultrasound (CD US) were done at the start of the study and reevaluation by CD US was done at 0, 3 and 6 months post band ligation sessions. Results: There was decrease in number of EVs columns and grading after 3 and 6 months with increase in number of cases of severe gastropathy after band ligation, Splenic artery RI and PI, Hepatic artery RI and PI and Renal artery RI and PI were good predictors for (PH), and (EVs). There were no statistically significant difference between presence of collaterals pre banding and after (3 and 6 months) post banding by CDUS. Conclusion: Portal hemodynamics using CD UScan serve as an important tool in the follow-up of patients undergoing endoscopic intervention as in endoscopic variceal ligation.