P491 NEEDLE-KNIFE FISTULOTOMY AS A RESCUE ACCESS OF THE COMMON BILE DUCT IN CIRRHOTIC PATIENTS: FEASIBILITY AND OUTCOME

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Results: Thirty-two patients were stratified as Overt HE, 19 patients had a positive PHES and 30 patients had an EEG consistent with HE. H NMR spectroscopy could discriminate between patients and healthy controls (R2X=0.77, R2Y=0.45, Q2Y=0.27, sensitivity 60%, specificity 100%). Patients with cirrhosis had higher glucose and lower hippurate levels. Urine NMR profiles discriminated patients with and without OHE, with less robust validity (R2X=0.77, R2Y=0.34, Q2Y=0.19, sensitivity 80%, specificity 64%). Patients with OHE had higher histidine, citrate and creatinine levels. Urine NMR spectroscopy could not discriminate patients with abnormal PHES or EEG. Conclusions: Patients with cirrhosis have distinct urinary metabolic profiles compared to healthy controls and those with OHE have higher histidine, citrate and creatinine levels. H NMR spectroscopy cannot discriminate patients with or without abnormal PHES or EEG. Mass spectrometry may be a more useful platform for biomarker discovery in MHE.

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