Management of gastroesophageal varices in cirrhotic patients: current status and future directions



Título del documento: Management of gastroesophageal varices in cirrhotic patients: current status and future directions
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000411139
ISSN: 1665-2681
Autores: 1
2
1
Instituciones: 1Kanazawa Medical University, Department of Hepatology, Ishikawa. Japón
2Hiroshima City Hospital, Department of Internal Medicine, Hiroshima. Japón
Año:
Periodo: May-Jun
Volumen: 15
Número: 3
Paginación: 314-325
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico
Resumen en inglés 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 β-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
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Gastroenterología,
Terapéutica y rehabilitación,
Várices esofágicas,
Cirrosis hepática,
Profilaxis,
Elastografía,
Hipertensión portal,
Hemorragia digestiva
Keyword: Medicine,
Diagnosis,
Gastroenterology,
Therapeutics and rehabilitation,
Esophageal varices,
Digestive hemorrhage,
Hepatic cirrhosis,
Prophylaxis,
Elastography,
Portal hypertension
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