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Background and objective: Gastrin is a key gastrointestinal hormone that stimulates gastric acid secretion and is associated with an increased risk of peptic ulcers. Patients with liver cirrhosis often exhibit elevated serum gastrin levels. However, the extent to which this is attributable to impaired hepatic clearance or to gastric factors in the context of portal hypertensive mucosal changes remains unclear. In particular, data on the relationship between gastrin levels and parameters of portal hypertension, as well as on the dynamics of gastrin levels following transjugular intrahepatic portosystemic shunt (TIPS) placement, are lacking.

Method: Patients with advanced liver cirrhosis were assessed before TIPS placement and at 1 and 30 days thereafter. Baseline gastrin measurements were available for 74 patients. 68 patients had paired baseline and day 1 measurements and 34 patients had complete gastrin data at baseline, day 1 and day 30. The MELD score, cirrhosis aetiology, portal venous pressure, portosystemic pressure gradient, and presence of oesophageal varices were also recorded. Correlations between gastrin levels and clinical or haemodynamic parameters were analysed.

Result: Serum gastrin levels correlated significantly with the MELD score, a marker of liver dysfunction. Following TIPS placement, a significant increase in gastrin levels was observed both on day 1 and on day 30 compared with baseline values. No significant association was found between gastrin levels and parameters of portal hypertension, including portal venous pressure or portosystemic pressure gradient. Gastrin levels did not differ between patients with and without esophageal varices.

Summary: Serum gastrin levels in patients with cirrhosis are primarily associated with the severity of liver dysfunction rather than with hemodynamic markers of portal hypertension or the presence of varices. The significant increase in gastrin levels after TIPS supports the hypothesis of a further reduction in hepatic gastrin clearance due to portosystemic shunting. As proton pump inhibitors (PPIs) can further increase gastrin secretion and are frequently prescribed without a clear indication in patients with cirrhosis, their use should be critically evaluated.