HVPG is an approximate measurement of the pressure gradient between the WHVP (Wedge hepatic venous pressure) and the free hepatic venous pressures (FHPV). It provides a rough estimate of the pressure gradient between the portal vein and the inferior vena cava. It is indicated in hepato-biliary pathologies which have associated portal hypertension.

Indications in portal hypertension to: –

• 1. Assess the severity and progression of portal hypertension
• 2. Monitoring the efficacy and response to treatment
• 3. Helps in staging of liver disease

How is it done?

It is measured by introducing a catheter into a hepatic vein. First pressure is obtained in occluded-catheter position and then in the free-catheter position. The difference between the 2 give an approximate value of HVPG.

An HVPG of ≥5 mmHg defines portal hypertension.  A value >10 mmHg is termed as clinically significant portal hypertension.