Esophageal varices

References

Key articles

Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2017 Jan;65(1):310-35.Full text  Abstract

de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII - renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74.Full text  Abstract

Reference articles

1. Alter MJ. Epidemiology of hepatitis B in Europe and worldwide. J Hepatol. 2003;39 Suppl 1:S64-9.Full text  Abstract

2. Kim WR, Brown RS Jr, Terrault NA, et al. Burden of liver disease in the United States: summary of a workshop. Hepatology. 2002 Jul;36(1):227-42. Abstract

3. North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med. 1988 Oct 13;319(15):983-9. Abstract

4. Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med. 2010 Mar 4;362(9):823-32. Abstract

5. Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2017 Jan;65(1):310-35.Full text  Abstract

6. The Italian Liver Cirrhosis Project. Reliability of endoscopy in the assessment of variceal features. J Hepatol. 1987 Feb;4(1):93-8. Abstract

7. de Franchis R, Pascal JP, Ancona E, et al. Definitions, methodology and therapeutic strategies in portal hypertension. A consensus development workshop, Baveno, Lake Maggiore, Italy, April 5 and 6, 1990. J Hepatol. 1992 May;15(1-2):256-61. Abstract

8. Groszmann RJ, Garcia-Tsao G, Bosch J, et al; Portal Hypertension Collaborative Group. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med. 2005 Nov 24;353(21):2254-61.Full text  Abstract

9. Merli M, Nicolini G, Angeloni S, et al. Incidence and natural history of small esophageal varices in cirrhotic patients. J Hepatol. 2003 Mar;38(3):266-72. Abstract

10. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789-858.Full text  Abstract

11. Mokdad AA, Lopez AD, Shahraz S, et al. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Med. 2014 Sep 18;12:145.Full text  Abstract

12. Bosetti C, Levi F, Lucchini F, et al. Worldwide mortality from cirrhosis: an update to 2002. J Hepatol. 2007 May;46(5):827-39. Abstract

13. Leon DA, McCambridge J. Liver cirrhosis mortality rates in Britain from 1950 to 2002: an analysis of routine data. Lancet. 2006 Jan 7;367(9504):52-6. Abstract

14. Centers for Disease Control and Prevention: National Center for Health Statistics. FastStats: chronic liver disease and cirrhosis. 2021[internet publication].Full text

15. Scaglione S, Kliethermes S, Cao G, et al. The epidemiology of cirrhosis in the United States: a population-based study. J Clin Gastroenterol. 2015 Sep;49(8):690-6. Abstract

16. World Gastroenterology Organisation. WGO global guidelines: esophageal varices. Jan 2014 [internet publication].Full text

17. Jairath V, Rehal S, Logan R, et al. Acute variceal haemorrhage in the United Kingdom: patient characteristics, management and outcomes in a nationwide audit. Dig Liver Dis. 2014 May;46(5):419-26. Abstract

18. Tapper EB, Beste L, Curry M, et al. Suboptimal implementation of evidence-based therapy for acute variceal hemorrhage: a systematic review of observational studies. Clin Gastroenterol Hepatol. 2017 Sep;15(9):1373-81.e7. Abstract

19. D'Amico G, Pagliaro L, Bosch J. Pharmacological treatment of portal hypertension: an evidence-based approach. Semin Liver Dis. 1999;19(4):475-505. [Published correction appears in Semin Liver Dis. 2000;20(3):399.] Abstract

20. Pinzani M, Gentilini P. Biology of hepatic stellate cells and their possible relevance in the pathogenesis of portal hypertension in cirrhosis. Semin Liver Dis. 1999;19(4):397-410. Abstract

21. Thalheimer U, Triantos CK, Samonakis DN, et al. Infection, coagulation, and variceal bleeding in cirrhosis. Gut. 2005 Apr;54(4):556-63.Full text  Abstract

22. Villanueva C, Albillos A, Genescà J, et al. Development of hyperdynamic circulation and response to beta-blockers in compensated cirrhosis with portal hypertension. Hepatology. 2016 Jan;63(1):197-206.Full text  Abstract

23. Bell BP, Manos MM, Zaman A, et al. The epidemiology of newly diagnosed chronic liver disease in gastroenterology practices in the United States: results from population-based surveillance. Am J Gastroenterol. 2008 Nov;103(11):2727-36. Abstract

24. Blachier M, Leleu H, Peck-Radosavljevic M, et al. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol. 2013 Mar;58(3):593-608.Full text  Abstract

25. Young K, Liu B, Bhuket T, et al. Improved liver transplant waitlist mortality and lower risk of disease progression among chronic hepatitis C patients awaiting liver transplantation after the introduction of direct-acting antiviral therapies in the United States. J Viral Hepat. 2019 Mar;26(3):350-61. Abstract

26. Boyer TD. Portal hypertensive hemorrhage: pathogenesis and risk factors. Semin Gastrointest Dis. 1995 Jul;6(3):125-33. Abstract

27. Reiberger T, Bucsics T, Paternostro R, et al. Small esophageal varices in patients with cirrhosis - should we treat them? Curr Hepatol Rep. 2018;17(4):301-15.Full text  Abstract

28. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018 Apr;67(4):1560-99.Full text  Abstract

29. Berzigotti A, Seijo S, Arena U, et al. Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis. Gastroenterology. 2013 Jan;144(1):102-11.e1. Abstract

30. Colecchia A, Montrone L, Scaioli E, et al. Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis. Gastroenterology. 2012 Sep;143(3):646-54. Abstract

31. Takuma Y, Nouso K, Morimoto Y, et al. Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. Gastroenterology. 2013 Jan;144(1):92-101.e2. Abstract

32. Ravaioli F, Montagnani M, Lisotti A, et al. Noninvasive assessment of portal hypertension in advanced chronic liver disease: an update. Gastroenterol Res Pract. 2018 Jun 7;2018:4202091.Full text  Abstract

33. Calès P, Zabotto B, Meskens C, et al. Gastroesophageal endoscopic features in cirrhosis. Observer variability, interassociations, and relationship to hepatic dysfunction. Gastroenterology. 1990 Jan;98(1):156-62. Abstract

34. Berzigotti A, Bosch J, Boyer TD. Use of noninvasive markers of portal hypertension and timing of screening endoscopy for gastroesophageal varices in patients with chronic liver disease. Hepatology. 2014 Feb;59(2):729-31.Full text  Abstract

35. Augustin S, Pons M, Maurice JB, et al. Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease. Hepatology. 2017 Dec;66(6):1980-8.Full text  Abstract

36. de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII - renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74.Full text  Abstract

37. Tripathi D, Stanley AJ, Hayes PC, et al. UK guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut. 2015 Nov;64(11):1680-704.Full text  Abstract

38. McCarty TR, Afinogenova Y, Njei B. Use of wireless capsule endoscopy for the diagnosis and grading of esophageal varices in patients with portal hypertension: a systematic review and meta-analysis. J Clin Gastroenterol. 2017 Feb;51(2):174-82.Full text  Abstract

39. Colli A, Gana JC, Turner D, et al. Capsule endoscopy for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis. Cochrane Database Syst Rev. 2014 Oct 1;(10):CD008760.Full text  Abstract

40. D'Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006 Jan;44(1):217-31. Abstract

41. The general rules for recording endoscopic findings of esophageal varices. Jpn J Surg. 1980 Mar;10(1):84-7. Abstract

42. Reliability of endoscopy in the assessment of variceal features. The Italian Liver Cirrhosis Project. J Hepatol. 1987 Feb;4(1):93-8. Abstract

43. Jangouk P, Turco L, De Oliveira A, et al. Validating, deconstructing and refining Baveno criteria for ruling out high-risk varices in patients with compensated cirrhosis. Liver Int. 2017 Aug;37(8):1177-83.Full text  Abstract

44. European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 Aug;69(2):406-60.Full text  Abstract

45. Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013 Jan 3;368(1):11-21. [Erratum in: N Engl J Med. Jun 13;368(24):2341.]Full text  Abstract

46. Abraham NS, Barkun AN, Sauer BG, et al. American College of Gastroenterology-Canadian Association of Gastroenterology clinical practice guideline: management of anticoagulants and antiplatelets during acute gastrointestinal bleeding and the periendoscopic period. Am J Gastroenterol. 2022 Apr 1;117(4):542-58.Full text  Abstract

47. Fernández J, Ruiz del Arbol L, Gómez C, et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006 Oct;131(4):1049-56. Abstract

48. European Medicines Agency. Quinolone- and fluoroquinolone-containing medicinal products. Mar 2019 [internet publication].Full text

49. Food and Drug Administration. FDA drug safety communication: FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Jul 2018 [internet publication].Full text

50. Food and Drug Administration. FDA drug safety communication: FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Dec 2018 [internet publication].Full text

51. Gøtzsche PC, Hróbjartsson A. Somatostatin analogues for acute bleeding oesophageal varices. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD000193.Full text  Abstract

52. Wells MC, Chande N, Adams P, et al. Meta-analysis: vasoactive medications for the management of acute variceal bleeds. Aliment Pharmacol Ther. 2012 Jun;35(11):1267-78. Abstract

53. Hwang JH, Shergill AK, Acosta RD, et al; ASGE Standards of Practice Committee. The role of endoscopy in the management of variceal hemorrhage. Gastrointest Endosc. 2014 Aug;80(2):221-7.Full text  Abstract

54. Vadera S, Yong CWK, Gluud LL, et al. Band ligation versus no intervention for primary prevention of upper gastrointestinal bleeding in adults with cirrhosis and oesophageal varices. Cochrane Database Syst Rev. 2019 Jun 20;(6):CD012673.Full text  Abstract

55. Lv Y, Yang Z, Liu L, et al. Early TIPS with covered stents versus standard treatment for acute variceal bleeding in patients with advanced cirrhosis: a randomised controlled trial. Lancet Gastroenterol Hepatol. 2019 Aug;4(8):587-98. Abstract

56. Lee EW, Eghtesad B, Garcia-Tsao G, et al. AASLD Practice Guidance on the use of TIPS, variceal embolization, and retrograde transvenous obliteration in the management of variceal hemorrhage. Hepatology. 2024 Jan 1;79(1):224-50.Full text  Abstract

57. Wright G, Lewis H, Hogan B, et al. A self-expanding metal stent for complicated variceal hemorrhage: experience at a single center. Gastrointest Endosc. 2010;71:71-8. Abstract

58. Garcia-Tsao G, Bosch J. Varices and variceal hemorrhage in cirrhosis: a new view of an old problem. Clin Gastroenterol Hepatol. 2015 Nov;13(12):2109-17. Abstract

59. Thiele M, Krag A, Rohde U, et al. Meta-analysis: banding ligation and medical interventions for the prevention of rebleeding from oesophageal varices. Aliment Pharmacol Ther. 2012 May;35(10):1155-65. Abstract

60. Hernández-Gea V, Procopet B, Giráldez Á, et al. Preemptive-TIPS improves outcome in high-risk variceal bleeding: an observational study. Hepatology. 2019 Jan;69(1):282-93.Full text  Abstract

61. Triantafyllou T, Aggarwal P, Gupta E, et al. Polytetrafluoroethylene-covered stent graft versus bare stent in transjugular intrahepatic portosystemic shunt: systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A. 2018 Jul;28(7):867-79. Abstract

62. Copelan A, Kapoor B, Sands M. Transjugular intrahepatic portosystemic shunt: indications, contraindications, and patient work-up. Semin Intervent Radiol. 2014 Sep;31(3):235-42.Full text  Abstract

63. D'Amico G, Garcia-Pagan JC, Luca A, et al. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: a systematic review. Gastroenterology. 2006 Nov;131(5):1611-24. Abstract

64. Bernard B, Grangé JD, Khac EN, et al. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology. 1999 Jun;29(6):1655-61. Abstract

65. Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, et al. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD002907.Full text  Abstract

66. Sauerbruch T, Mengel M, Dollinger M, et al. Prevention of rebleeding from esophageal varices in patients with cirrhosis receiving small-diameter stents versus hemodynamically controlled medical therapy. Gastroenterology. 2015 Sep;149(3):660-8.Full text  Abstract

67. Abraldes JG, Villanueva C, Aracil C, et al; BLEPS Study Group. Addition of simvastatin to standard therapy for the prevention of variceal rebleeding does not reduce rebleeding but increases survival in patients with cirrhosis. Gastroenterology. 2016 May;150(5):1160-70.e3. Abstract

68. Chirica M, Kelly MD, Siboni S, et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019;14:26.Full text  Abstract

69. Tripathi D, Hayes PC. The role of carvedilol in the management of portal hypertension. Eur J Gastroenterol Hepatol. 2010 Aug;22(8):905-11. Abstract

70. Henderson JM, Boyer TD, Kutner MH, et al. Distal splenorenal shunt versus transjugular intrahepatic portal systematic shunt for variceal bleeding: a randomized trial. Gastroenterology. 2006 May;130(6):1643-51. Abstract

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