The Role of Endoscopy for Primary and Secondary Prophylaxis of Variceal Bleeding

Gastrointest Endosc Clin N Am. 2024 Apr;34(2):231-248. doi: 10.1016/j.giec.2023.09.012. Epub 2023 Oct 20.

Abstract

Cirrhosis is associated with a high morbidity and mortality. One of the most serious and unpredictable complication of cirrhosis, with a high mortality rate, is bleeding from esophagogastric varices. Endoscopic screening of varices followed by primary prophylactic treatment with beta blockers or band ligation in the presence of large esophageal varices will reduce the variceal bleeding rates and thereby reduce mortality risks in those with advanced cirrhosis. There is a paucity of data on primary prophylaxis of gastric varices but secondary prophylaxis includes glue injection, balloon-occluded retrograde transvenous obliteration, or transjugular intrahepatic portosystemic shunting with coil embolization.

Keywords: Cirrhosis; Esophageal; Gastric; Prophylaxis; Varices.

Publication types

  • Review

MeSH terms

  • Endoscopy, Gastrointestinal / adverse effects
  • Esophageal and Gastric Varices* / complications
  • Esophageal and Gastric Varices* / therapy
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control
  • Humans
  • Liver Cirrhosis / complications
  • Varicose Veins*