title: Secondary prophylaxis for esophageal variceal bleeding.
abstract: Combination therapy with beta-blockers and endoscopic band ligation (EBL) is the standard prophylaxis of esophageal variceal rebleeding in cirrhosis. Beta-blockers are the backbone of combination therapy, since their benefit extend to other complications of portal hypertension. EBL carries the risk of post-banding ulcer bleeding, which explains why overall rebleeding is reduced when beta-blockers are added to EBL, and not when EBL is added to beta-blockers. TIPS is the rescue treatment, but it could be considered as first choice in patients that first bleed while on beta-blockers, those with contraindications to beta-blockers or with refractory ascites, and those with fundal varices.
authors.affiliation: Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, CIBERehd, IRYCIS, University of Alcalá, Ctra. Colmenar km. 9.100, Madrid 28034, Spain. Electronic address: aalbillosm@meditex.es.
authors.forename: Agustín
authors.initials: A
authors.lastname: Albillos
authors.affiliation: Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Ctra. Colmenar km 9.100, Madrid 28034, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Tejedor
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D008026:Ligation; D017082:Portal Pressure / Q000187:drug effects; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Endoscopic band ligation; Hemodynamic responders; Secondary prophylaxis; Transjugular intrahepatic portosystemic shunt (TIPS); Variceal rebleeding; β-blockers