[Prevention of esophageal variceal bleeding].
Esophageal varices(EV) are present in 40% and 60% of Child-Pugh A and C patients, respectively when cirrhosis is diagnosed. EV bleeding is a life-threatening complication of liver cirrhosis with a high probability of recurrence. Treatment to prevent first EV bleeding or rebleeding is mandatory. In small EV with high risk of bleeding, nonselective β-blockers should be used for the prevention of first variceal bleeding. For medium to large EV, nonselective β-blockers or endoscopic variceal ligation (EVL) may be recommended to high risk varices. But, nonselective β-blockers are the first treatment option to non-high risk varices and EVL is an alternative when nonselective β-blockers are contraindicated or not tolerated. For the prevention of rebleeding, a combination of nonselective β-blockers and EVL may be the best option. A great improvement in the prevention of variceal bleeding has emerged over the last years. However, further therapeutic options that combine higher efficacy, better tolerance and fewer side effects are needed.
Lee
Chang Hyeong
CH
Department of Internal Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea. chlee1@cu.ac.kr
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000517:prevention & control*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008026:Ligation; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D015911:Sclerotherapy
D000319:Adrenergic beta-Antagonists