There were more mild PEP rates recorded in 5Fr group (93% vs 56% P = 0.0549) that was not statistically significant. There appears to be no relationship
between stent characteristics and the risk or severity of PEP in patients with manometrically proven SOD. “
“Information on the find more long-term prognosis of nonalcoholic fatty liver disease (NAFLD) is limited. We sought to describe the long-term morbidity and mortality of patients with NAFLD with advanced fibrosis or cirrhosis by prospectively studying 247 such patients from four international centers (in Australia, USA, UK and Italy). Their natural history was then compared with 264 patients with HCV infection who were either naïve or non-responders to treatment. Both cohorts were Child-Pugh class A and had advanced fibrosis (stage 3) or cirrhosis (stage 4) confirmed by liver biopsy at enrollment. In the NAFLD cohort, followed up for a
mean of 85.6 months (range, 6-297), there were 48 (19.4%) liver-related complications and 33 (13.4%) deaths or liver transplants. In the HCV cohort, followed up for 74.9 months (mean; range, 6-238), there were 47 (16.7%) liver-related complications and 25 (9.4%) deaths or liver transplants. When adjusting for baseline differences in age and gender, the cumulative incidence of liver-related complications was lower in the NAFLD than the HCV cohort (P = 0.03), including incident hepatocellular cancer (6 versus 18; P = 0.03), but that of cardiovascular events (P = 0.17) and overall mortality (P = 0.6) were similar in both groups. In the NAFLD cohort, platelet count, stage 4 fibrosis, lowered platelet 4-Aminobutyrate aminotransferase count, and lowered serum cholesterol and alanine aminotrasferase ABT-737 molecular weight (ALT) levels were associated with liver-related complications; an aspartate aminotransferase/ALT ratio >1 and older age were associated with overall mortality, and higher serum bilirubin levels and stage 4 fibrosis were associated with liver-related mortality. Conclusions: Patients with NAFLD with advanced fibrosis or cirrhosis have lower rates of liver-related complications and hepatocellular cancer than corresponding patients
with HCV infection, but similar overall mortality. Some clinical and laboratory features predict liver-related complications and other outcomes in patients with NAFLD. (HEPATOLOGY 2011;54:1208–1216) Nonalcoholic fatty liver disease (NAFLD) has become the most prevalent cause of chronic liver disease worldwide.1-3 Regarded as the hepatic manifestation of the metabolic syndrome, NAFLD represents a histological spectrum of disease that extends from simple steatosis to steatohepatitis (NASH).1-5 NAFLD may be associated with advanced fibrosis or cirrhosis, which is a concern, as many of the liver-related complications and mortality (e.g., liver failure, varices, etc.) occur in these patients.6 In addition to an increasing need for transplantation,7 patients with NAFLD with and without cirrhosis may also develop hepatocellular cancer (HCC).