Conclusions
Les traitements endoscopiques sont efficaces aussi bien dans le traitement en urgence des hémorragies par rupture de VO que dans le traitement préventif des récidives, associés ou non aux bêtabloquants. Les bêtabloquants sont aussi efficaces que les traitements endoscopiques et doivent être utilisés en première intention, sauf en cas d’hémorragie persistante ou récidivante. En cas d’échec ou de non disponibilité des bêta-bloquants, le recours aux techniques endoscopiques est légitime. Le choix des techniques sera fonction des possibilités locales, la sclérose dont l’efficacité est identique à celle de la ligature et des bêtabloquants garde donc ses indications.
Conclusions
Endoscopie treatments are effective for emergency hemostasis or for the prevention of variceal relapses, whether or not used in association with beta-blockers. Beta-blockers are as effective as endoscopic treatment and must be used as a first line treatment, except in cases of persistent bleeding or relapse. Where beta-blockers are inefficient or unavailable, endoscopic techniques are necessary. The choice of technique will depend on what is available locally. Sclerosis, which is as efficient as band ligation or beta-blockers, remains a viable proposition.
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Florent, C. Traitement de l’hypertension portale: quel traitement pour les pays émergents?. Acta Endosc 34, 679–690 (2004). https://doi.org/10.1007/BF03009077
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DOI: https://doi.org/10.1007/BF03009077