Baveno VII Algorithm can be Used to Exclude Varices Needing Treatment in MASLD Related Compensated Advanced…

Cohort studyJournal of clinical and experimental hepatology· Sep 2026

Baveno VII Algorithm can be Used to Exclude Varices Needing Treatment in MASLD Related Compensated Advanced Chronic Liver DiseasePatients.

Chitranshu Vashishtha, Ankit Bhardwaj, Shalini Thapar Laroia … Shiv K Sarin

GastroenterologyCohort studyDiagnosisQ2IF 2.4

Baveno VII algorithm let more patients avoid endoscopy than Baveno VI algorithm.

Baveno VII Algorithm can be Used to Exclude Varices Needing Treatment in MASLD Related Compensated Advanced Chronic Liver DiseasePatients.

Chitranshu Vashishtha … Shiv K Sarin

Journal of clinical and experimental hepatology · Sep 2026

Background

Baveno VII guidelines recommend avoiding screening esophagogastroduodenoscopy (esophagogastroduodenoscopy) in patients with compensated advanced chronic liver disease (cACLD) in patients with spleen stiffness ≤40 kPa among those patients who do not fulfil the Baveno VI criteria.

Purpose

We aimed to validate the performance of Baveno VII algorithm in patients with metabolic dysfunction-associated chronic liver disease (MASLD) related cACLD.

Methods

Consecutive patients of MASLD-related cACLD undergoing liver and spleen stiffness measurement (LSM and SSM) using a 100 Hz module and screening esophagogastroduodenoscopy within 1 month were prospectively enrolled.

n = 1051 patients

Results

31.4% of patients avoided endoscopy using Baveno VII, versus 18.5% with Baveno VI.

31.4%

Baveno VII

18.5%

Baveno VI

More results

Overall, varices needing treatment (varices needing treatment) were seen in 104 (32%) patients.

3.3%.

Among obese patients, esophagogastroduodenoscopy spare rate was (33.4% vs 22.5%, P = 0.009) with a miss rate of 3% vs.1.5%.

More results

Other models had miss varices needing treatment rates >5%, i.e., 8.7% expanded Baveno VI algorithm, 14.4% AST-platelet ratio index (AST-platelet ratio index), 16.3% platelet-spleen ratio (platelet-spleen ratio), 33.6% LS-spleen diameter to platelet ratio score (LSPS), 23.1% Fib-4 and 21.2% Rete Sicilia Selezione Terapia (Rete Sicilia Selezione Terapia) criteria.

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Conclusion · 1 of 2

The Baveno VII algorithm was superior to Baveno VI and other models in ruling out varices needing treatment in patients with MASLD-related cACLD, including those with diabetes and obesity.

Conclusion · 2 of 2

Metabolic dysfunction associated chronic liver disease (MASLD) is one of the most common causes of liver cirrhosis worldwide. Upper gastrointestinal endoscopy is the standard for screening esophageal varices in patients with cirrhosis.

Baveno VII Algorithm can be Used to Exclude Varices Needing Treatment in MASLD Related Compensated Advanced Chronic Liver DiseasePatients.

Baveno VII Algorithm can be Used to Exclude Varices Needing Treatment in MASLD Related Compensated Advanced Chronic Liver DiseasePatients.

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