The need for gastroscopy in early cirrhotics : a retrospective analytical study

Abstract

The aim of this study was to predict which Child-A cirrhotic patients would not have oesophageal varices at endoscopy. This is a retrospective study that reviewed 59 Child-A cirrhotic patients under the care of a gastroenterology firm. All gastroscopy reports (97 episodes in total) undergone by these patients were analysed. Patients were classified into 3 groups namely absent varices (AV) group: no oesophageal varices seen at endoscopy, small varices (SV) group: small oesophageal varices seen, banded varices (BV) group: moderate/large oesophageal varices requiring banding. In this study the varices were graded as per UK guidelines that is small varices being ones which collapse to inflation of the oesophagus with air, moderate varices do not collapse and large varices occlude the lumen.1 Patient demographics, a platelet count and spleen size on imaging at the time of endoscopy were also noted. Statistical differences between the 3 groups were then analysed using ANOVA. Our results showed that most of the patients were middle aged males. Furthermore, there was a statistically significant difference in platelet count and spleen size between the three groups (p values: 0.008 and 0.035 respectively). A noteworthy finding was that none of the patients who required banding had a normal spleen size (spleen < 12 cm). Having said this, due to considerable overlap between the three groups, further recommendations could not be proposed.