Primary prevention of bleeding from esophageal varices in patients with liver cirrhosis |
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Authors: | Christos Triantos Maria Kalafateli |
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Affiliation: | Christos Triantos, Maria Kalafateli, Department of Gastroenterology, University Hospital of Patras, 26500 Patras, Greece |
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Abstract: | Variceal bleeding is a life threatening situation with mortality rates of at least 20%. Prophylactic treatment with non-selective beta blockers(NSBBs) is recommended for patients with small varices that have not bled but with increased risk for bleeding. The recommended treatment strategies on primary prevention of variceal bleeding in patients with medium and largesized varices are NSBBs or endoscopic band ligation. Nitrates, shunt surgery and sclerotherapy are not recommended in this setting. In this review, the most recent data on prevention of esophageal variceal bleeding are presented. Available data derived from randomized-controlled trials suggest both treatment strategies, and according to Baveno V consensus in portal hypertension "the choice of treatment should be based on local resources and expertise, patient preference and characteristics, side-effects and contra-indications". |
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Keywords: | Cirrhosis Portal hypertension Esophageal varices Primary prevention β-Blockers Endoscopic band ligation |
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