Publication Name	World Journal of Gastrointestinal Pathophysiology
Manuscript ID	122115
DOI	10.4291/wjgp.122115
Country	India

Category	Gastroenterology & Hepatology
Manuscript Type	Minireviews
Article Title	Pathophysiological management of gastric varices: From hemodynamics to targeted therapies
Manuscript Source	Invited Manuscript
All Author List	Suprabhat Giri, Ranjan K Patel, Tara Prasad Tripathy, Dibya Lochan Praharaj and Radhika Chavan
Funding Agency and Grant Number
Corresponding Author	Suprabhat Giri, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Kushabhadra Campus, 5, KIIT Rd, Patia, Bhubaneswar 751024, Odisha, India. supg19167@gmail.com
Key Words	Gastric varices; Portal hypertension; Balloon-occluded retrograde transvenous obliteration; Transjugular intrahepatic portosystemic shunt; Endoscopic ultrasound
Core Tip	Gastric varices require a pathophysiology-driven management strategy distinct from esophageal varices. Therapy selection should be guided by hemodynamic classification, integrating Sarin (location), Kiyosue and Saad-Caldwell (inflow-outflow anatomy), and clinical factors. Shunt-dominant varices are best treated with Balloon-occluded retrograde transvenous obliteration or its variants, while pressure-dominant disease requires a transjugular intrahepatic portosystemic shunt for global decompression. Endoscopic ultrasound-guided coil ± glue therapy offers precise, flow-directed treatment in complex anatomy or high-risk patients. Clinical modifiers such as hepatic encephalopathy, ascites, liver reserve, and portal vein patency are critical in decision-making. A multidisciplinary approach combining endoscopic, radiologic, and surgical modalities is essential for optimal and durable outcomes.
Citation	Giri S, Patel RK, Tripathy TP, Praharaj DL, Chavan R. Pathophysiological management of gastric varices: From hemodynamics to targeted therapies. World J Gastrointest Pathophysiol 2026; In press DOI: https://doi.org/10.4291/wjgp.122115

Received	2026-04-10 06:21
Peer-Review Started	2026-04-10 06:22
First Decision by Editorial Office Director	2026-04-29 10:34
Return for Revision	2026-04-29 10:34
Revised	2026-05-25 01:08
Publication Fee Transferred
Second Decision by Editor	2026-06-12 02:34
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-12 06:33
Articles in Press	2026-06-12 06:33
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2150-5330 (online)
Open Access	Open-Access: This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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