Management of gastroesophageal varices in cirrhotic patients: current status and future directions.
Ann Hepatol
; 15(3): 314-25, 2016.
Article
em En
| MEDLINE
| ID: mdl-27049485
ABSTRACT
Bleeding from gastroesophageal varices (GEV) is a serious event in cirrhotic patients and can cause death. According to the explosion theory, progressive portal hypertension is the primary mechanism underlying variceal bleeding. There are two approaches for treating GEV primary prophylaxis to manage bleeding or emergency treatment for bleeding followed by secondary prophylaxis. Treatment methods can be classified into two categories 1) Those used to decrease portal pressure, such as medication (i.e., nonselective ß-blockers), radiological intervention [transjugular intrahepatic portosystemic shunt (TIPS)] or a surgical approach (i.e., portacaval shunt), and 2) Those used to obstruct GEV, such as endoscopy [endoscopic variceal ligation (EVL), endoscopic injection sclerotherapy (EIS), and tissue adhesive injection] or radiological intervention [balloon-occluded retrograde transvenous obliteration (BRTO)]. Clinicians should choose a treatment method based on an understanding of its efficacy and limitations. Furthermore, elastography techniques and serum biomarkers are noninvasive methods for estimating portal pressure and may be helpful in managing GEV. The impact of these advances in cirrhosis therapy should be evaluated for their effectiveness in treating GEV.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Varizes Esofágicas e Gástricas
/
Técnicas Hemostáticas
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Derivação Portossistêmica Transjugular Intra-Hepática
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Hemorragia Gastrointestinal
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Cirrose Hepática
/
Anti-Hipertensivos
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Ann Hepatol
Ano de publicação:
2016
Tipo de documento:
Article