Interventions for primary prevention of esophageal variceal bleeding

Abstract

Current guidelines recommend cirrhotic patients undergo endoscopic screening for varices, unless patients have liver stiffness <20kPa and platelet count >150x10⁹/L¹. Screening for varices presumes we can offer an intervention to reduce risk of first variceal hemorrhage and, ideally, death. Because risk of bleeding increases with variceal size, guidelines recommend patients with medium‐large esophageal varices receive endoscopic variceal band ligation (VBL), non‐selective β‐blockers (NSBB), or carvedilol as primary preventive therapy to reduce first variceal hemorrhage.

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