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Variceal bleeding and portal hypertension: much to learn, much to explore.
Endoscopy. 2002 Feb; 34(2):119-28.E

Abstract

The newer diagnostic and therapeutic options continue to evolve and important developments have been made in the field of variceal bleeding and portal hypertension. A meeting was held at Baveno to update consensus on different terminologies in relation to portal hypertension. beta-blockers continue to be the mainstay for primary prophylaxis of variceal bleeding, and endoscopic variceal ligation (EVL) is fast emerging as a strong contender. The role of vasoactive drugs in the management of variceal bleeding was assessed. Octreotide and terlipressin were shown to be as effective as sclerotherapy in achieving initial hemostasis, and octreotide was shown to be safe and efficacious in the prevention of rebleeding. EVL was superior to endoscopic sclerotherapy (EST) for obliteration of esophageal varices. Sequential and simultaneous ligation and sclerotherapy were more effective than ligation alone, in reducing the recurrence rate after variceal obliteration. For gastric varices, cyanoacrylate glue continues to be the first line of treatment, and band ligation is being assessed further. Bleeding ectopic varices were dealt by appropriate endoscopic means. Endosonography has developed strongly in the assessment of variceal eradication and prediction of variceal recurrence. Transjugular intrahepatic portosystemic shunting (TIPS) significantly reduces rebleeding rates compared to EVL.

Authors+Show Affiliations

Dept. of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. dkbhasin@sancharnet.inNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11822007

Citation

Bhasin, D K., and N J S. Malhi. "Variceal Bleeding and Portal Hypertension: Much to Learn, Much to Explore." Endoscopy, vol. 34, no. 2, 2002, pp. 119-28.
Bhasin DK, Malhi NJ. Variceal bleeding and portal hypertension: much to learn, much to explore. Endoscopy. 2002;34(2):119-28.
Bhasin, D. K., & Malhi, N. J. (2002). Variceal bleeding and portal hypertension: much to learn, much to explore. Endoscopy, 34(2), 119-28.
Bhasin DK, Malhi NJ. Variceal Bleeding and Portal Hypertension: Much to Learn, Much to Explore. Endoscopy. 2002;34(2):119-28. PubMed PMID: 11822007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variceal bleeding and portal hypertension: much to learn, much to explore. AU - Bhasin,D K, AU - Malhi,N J S, PY - 2002/2/1/pubmed PY - 2002/3/7/medline PY - 2002/2/1/entrez SP - 119 EP - 28 JF - Endoscopy JO - Endoscopy VL - 34 IS - 2 N2 - The newer diagnostic and therapeutic options continue to evolve and important developments have been made in the field of variceal bleeding and portal hypertension. A meeting was held at Baveno to update consensus on different terminologies in relation to portal hypertension. beta-blockers continue to be the mainstay for primary prophylaxis of variceal bleeding, and endoscopic variceal ligation (EVL) is fast emerging as a strong contender. The role of vasoactive drugs in the management of variceal bleeding was assessed. Octreotide and terlipressin were shown to be as effective as sclerotherapy in achieving initial hemostasis, and octreotide was shown to be safe and efficacious in the prevention of rebleeding. EVL was superior to endoscopic sclerotherapy (EST) for obliteration of esophageal varices. Sequential and simultaneous ligation and sclerotherapy were more effective than ligation alone, in reducing the recurrence rate after variceal obliteration. For gastric varices, cyanoacrylate glue continues to be the first line of treatment, and band ligation is being assessed further. Bleeding ectopic varices were dealt by appropriate endoscopic means. Endosonography has developed strongly in the assessment of variceal eradication and prediction of variceal recurrence. Transjugular intrahepatic portosystemic shunting (TIPS) significantly reduces rebleeding rates compared to EVL. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/11822007/Variceal_bleeding_and_portal_hypertension:_much_to_learn_much_to_explore_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2002-19845 DB - PRIME DP - Unbound Medicine ER -