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Portal hypertension: pre-primary and primary prophylaxis of variceal bleeding.
Dig Liver Dis. 2008 May; 40(5):318-27.DL

Abstract

In liver cirrhosis, variceal bleeding is the last in a chain of events initiated by the increase in portal pressure (estimated in clinical practice by the hepatic venous pressure gradient). When hepatic venous pressure gradient goes above 10 mmHg the patient is at risk of developing varices, and when hepatic venous pressure gradient reaches 12 mmHg variceal bleeding might develop. Currently, there is not any effective therapy for the prevention of the development of varices. When varices are small, beta-adrenergic blockers might prevent the enlargement of the varices, and may reduce the risk of variceal bleeding. In patients with medium to large varices, beta-blockers are clearly effective in reducing the risk of variceal bleeding. Endoscopic band ligation might be more effective than beta-blockers, but available evidence is still very weak.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Tiani C
Hepatic Hemodynamic Laboratory, Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Spain.
Abraldes JG
No affiliation info available
Bosch J
No affiliation info available

MeSH

Adrenergic beta-AntagonistsEndoscopy, GastrointestinalEsophageal and Gastric VaricesGastrointestinal HemorrhageHumansHypertension, PortalIncidenceLigationPrevalencePrognosisSclerotherapy

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18291732

Citation

Tiani, C, et al. "Portal Hypertension: Pre-primary and Primary Prophylaxis of Variceal Bleeding." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 40, no. 5, 2008, pp. 318-27.
Tiani C, Abraldes JG, Bosch J. Portal hypertension: pre-primary and primary prophylaxis of variceal bleeding. Dig Liver Dis. 2008;40(5):318-27.
Tiani, C., Abraldes, J. G., & Bosch, J. (2008). Portal hypertension: pre-primary and primary prophylaxis of variceal bleeding. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 40(5), 318-27. https://doi.org/10.1016/j.dld.2007.12.004
Tiani C, Abraldes JG, Bosch J. Portal Hypertension: Pre-primary and Primary Prophylaxis of Variceal Bleeding. Dig Liver Dis. 2008;40(5):318-27. PubMed PMID: 18291732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Portal hypertension: pre-primary and primary prophylaxis of variceal bleeding. AU - Tiani,C, AU - Abraldes,J G, AU - Bosch,J, Y1 - 2008/03/04/ PY - 2007/12/05/received PY - 2007/12/05/accepted PY - 2008/2/23/pubmed PY - 2008/7/4/medline PY - 2008/2/23/entrez SP - 318 EP - 27 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 40 IS - 5 N2 - In liver cirrhosis, variceal bleeding is the last in a chain of events initiated by the increase in portal pressure (estimated in clinical practice by the hepatic venous pressure gradient). When hepatic venous pressure gradient goes above 10 mmHg the patient is at risk of developing varices, and when hepatic venous pressure gradient reaches 12 mmHg variceal bleeding might develop. Currently, there is not any effective therapy for the prevention of the development of varices. When varices are small, beta-adrenergic blockers might prevent the enlargement of the varices, and may reduce the risk of variceal bleeding. In patients with medium to large varices, beta-blockers are clearly effective in reducing the risk of variceal bleeding. Endoscopic band ligation might be more effective than beta-blockers, but available evidence is still very weak. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/18291732/Portal_hypertension:_pre_primary_and_primary_prophylaxis_of_variceal_bleeding_ DB - PRIME DP - Unbound Medicine ER -