Primary Prevention of Variceal Hemorrhage

Patients with esophageal varices but without histories of variceal bleeding have a 2-year risk for first variceal hemorrhage of 25% to 40% if they do . . .

Patients with esophageal varices but without histories of variceal bleeding have a 2-year risk for first variceal hemorrhage of 25% to 40% if they do not receive prophylactic treatment. Prophylaxis is recommended for patients who have medium-sized or large varices. Use of β-blockers has been the mainstay of treatment, mainly because of their low cost and ease of use. Band ligation is an alternative — especially when contraindications or intolerance to β-blockers exists.

This study is the first randomized multicenter controlled trial in which a multishot endoscopic rubber-band ligation device was compared with propranolol therapy for preventing first esophageal variceal hemorrhage. Exclusion criteria were numerous and included severe coagulop…

Reviewing Author

David A. Johnson, MD