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Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

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Summary

Prophylaxis of bleeding from esophageal varices is a very tempting concept at first glance, especially under the assumption of a high mortality associated with first variceal hemorrhage. Up to now four different measures have been tried for prophylaxis: portacaval shunt operation, devascularization procedures, sclerotherapy, and drugs. With the exception of portacaval shunts, ongoing controlled trials show a weak trend toward reduction of variceal bleeding and prolongation of survival in selected patients with compensated cirrhosis and large varices. However, prophylaxis of first variceal bleeding must still be regarded as experimental and should be restricted to controlled clinical studies.

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Abbreviations

ICG:

Indocyanine-green

WHVP/FHVP-gradient:

Wedged hepatic venous pressure minus free hepatic venous pressure gradient

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  1. Medizinische Klinik II, Klinikum Grosshadern, Universität München, Germany

    T. Sauerbruch, G. Kleber, A. Gerbes & G. Paumgartner

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  1. T. Sauerbruch
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  2. G. Kleber
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  3. A. Gerbes
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  4. G. Paumgartner
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Sauerbruch, T., Kleber, G., Gerbes, A. et al. Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis. Klin Wochenschr 64, 1267–1275 (1986). https://doi.org/10.1007/BF01785707

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