The operation also led to a marked decrease in type IV collagen 7s domain and des-y-carboxy prothrombin. In addition, B-RTO significantly decreased homeostasis model assessment (HOMA) of IR without a statistical decline of HOMA of p-cell function, suggesting a pronounced recovery from IR. The 75g oral glucose tolerance test (75-OGTT) revealed that occlusion of PSS reduced both fasting immunoreactive insulin (IRI) levels and the area under the curve for IRI, suggesting amelioration
of hyperinsulinemia in the fasting state Temsirolimus concentration and attenuation of the excessive insulin response to a glucose load. However, no significant change in preprandial or postprandial plasma glucose levels was observed. Furthermore, according to the criteria of the American Diabetes Association, B-RTO improved a 75-OGTT profile in 58.3% of patients who had impaired glucose tolerance or diabetes mellitus before the procedure. Preoperative factors statistically associated with an improvement in H〇MA-IR by B-RTO were sex=male, age<70 years, body
mass index<25, etiology=HCV, C-P class=A, and feeding vein of GV=Ieft gastric vein. Conclusions: Shunt occlusion attenuates IRrelated hyperinsulinemia through increased portal venous flow, promoted liver function, and conseguent augmented hepatic insulin clearance in cirrhotic patients with PH. Excessive insulin response and sustained hyperglycemia after meals are reportedly risk factors for both hepatic fibrosis and hepatocarcinogenesis, and thus B-RTO may be beneficial
for therapeutic management of patients with LC. Disclosures: The following people have nothing to disclose: this website Tsuyoshi Ishikawa, Takashi Matsuda, Takuya Iwamoto, Shuji Terai, Isao Sakaida [Background and Aim] Spleen stiffness (SS) can be easily measured using virtual touch guantification (VTQ), and it is expected to be important in identifying cirrhotic patients with esophageal varices (EVs). Portosystemic shunts (PSSs), which were developed to treat portal hypertension, can influence SS. However, the significance of SS for the prediction of EVs considering PSSs has not been well documented. next The aim of the present study was to determine the predictive value of SS for the presence and severity of EVs. [Patients and Methods] Between June 2008 and May 2013, 981 patients underwent liver stiffness measurement, and data on SS, EVs, and PSSs were available for 143 patients with chronic liver disease (hepatitis C virus, 86; hepatitis B virus, 19; alcoholic liver disease, 14; autoimmune hepatitis, 9; nonalcoholic steatohepatitis, 6; unknown, 9). VTQ was performed using a Siemens Acuson S2000. EVs evaluated using upper endoscopy were classified into the following 3 grades: F1, small, straight, disappearing on insufflation; F2, moderately sized, tortuous, occupying less than one-third of the lumen; and F3, large, coiled, occupying more than one-third of the lumen.