Hepatic venous pressure gradient is one of the main predictors of and the basic hydrodynamic reason for life-threatening bleeding in cirrhotic patients. It has been commonly admitted from the 90s that varices develop at a HVPG higher than 12 mmHg, and the higher HVPG the more frequent the patients tend to bleed. HPVG > 20 mmHg is considered as a significant prognostic indicator for bleeding from EVs to occur.
However, what was the highest portal pressure you have ever measured in your practice and have you encountered any special difficulty to achieve hemostasis in that case?
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