title: Primary prevention of variceal hemorrhage.
abstract: Variceal hemorrhage is one of the leading causes of death in patients with cirrhosis, with the 6-week mortality after each episode ranging from 15% to 20%. The two main strategies for primary prevention of variceal bleeding in patients with cirrhosis and varices are the administration of nonselective β-blockers or the obliteration of varices with use of endoscopic band ligation. In this review, we present and critically review the latest data on primary prevention of variceal hemorrhage. We advocate that nonselective β-blockers should be the first line therapy, and band ligation should be offered only in cases of intolerance or side effects. We also explore potential future therapies based on preliminary experimental and clinical data.
authors.affiliation: University Department of Surgery, Royal Free Hospital and UCL, Hampstead, London, UK. mtsochatzis@hotmail.com
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Tsochatzis
authors.forename: Christos K
authors.initials: CK
authors.lastname: Triantos
authors.forename: Matteo
authors.initials: M
authors.lastname: Garcovich
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Burroughs
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000517:prevention & control*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008026:Ligation / Q000379:methods; D008103:Liver Cirrhosis / Q000503:physiopathology; D011322:Primary Prevention / Q000379:methods / Q000639:trends
chemical_list: D000319:Adrenergic beta-Antagonists