Oesophageal varices in cirrhotic patients: From variceal screening to primary prophylaxis of the first oesophageal variceal bleeding

Chunqing Zhang, Dominique Thabut, Patrick S. Kamath, Vijay H. Shah

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Bleeding from oesophageal varices is still a lethal complication in cirrhotic patients with portal hypertension. Approximately 5-10% of patients with cirrhosis will develop oesophageal varices per year, and about 25-30% of cirrhotic patients with oesophageal varices and without previous variceal haemorrhage will bleed from ruptured varices. To date, data on preventing the formation/growth of oesophageal varices (preprimary prophylaxis) are conflicting, with insufficient evidence to use β-blockers. There is evidence for the need for primary prophylaxis, and both β-blockers and endoscopic variceal ligation have shown the same efficacy in preventing first bleeding, but which one to prefer is still controversial. The present article reviews the established and potential therapeutic strategies for preventing the development and rupture of oesophageal varices.

Original languageEnglish (US)
Pages (from-to)108-119
Number of pages12
JournalLiver International
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2011

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Keywords

  • Bleeding
  • Endoscopic oesophageal variceal ligation (EVL)
  • Oesophageal varices
  • Primary prevention β-blockers

ASJC Scopus subject areas

  • Hepatology

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