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. 2000 Jun;46(Suppl 3):iii1–iii15. doi: 10.1136/gut.46.suppl_3.iii1

UK guidelines on the management of variceal haemorrhage in cirrhotic patients

R Jalan, P Hayes
PMCID: PMC1766736  PMID: 10862604

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Figure 1  .

Figure 1  

Proposed algorithm for surveillance for varices and primary prophylaxis.

Figure 2  .

Figure 2  

Algorithm for the management of variceal haemorrhage. UGI, upper gastrointestinal; FU, follow up; TIPSS, transjugular intrahepatic portosystemic stent shunt.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alexandrino P. T., Alves M. M., Pinto Correia J. Propranolol or endoscopic sclerotherapy in the prevention of recurrence of variceal bleeding. A prospective, randomized controlled trial. J Hepatol. 1988 Oct;7(2):175–185. doi: 10.1016/s0168-8278(88)80480-x. [DOI] [PubMed] [Google Scholar]
  2. Andreani T., Poupon R. E., Balkau B. J., Trinchet J. C., Grange J. D., Peigney N., Beaugrand M., Poupon R. Preventive therapy of first gastrointestinal bleeding in patients with cirrhosis: results of a controlled trial comparing propranolol, endoscopic sclerotherapy and placebo. Hepatology. 1990 Dec;12(6):1413–1419. doi: 10.1002/hep.1840120624. [DOI] [PubMed] [Google Scholar]
  3. Angelico M., Carli L., Piat C., Gentile S., Rinaldi V., Bologna E., Capocaccia L. Isosorbide-5-mononitrate versus propranolol in the prevention of first bleeding in cirrhosis. Gastroenterology. 1993 May;104(5):1460–1465. doi: 10.1016/0016-5085(93)90356-h. [DOI] [PubMed] [Google Scholar]
  4. Avgerinos A., Armonis A., Manolakopoulos S., Poulianos G., Rekoumis G., Sgourou A., Gouma P., Raptis S. Endoscopic sclerotherapy versus variceal ligation in the long-term management of patients with cirrhosis after variceal bleeding. A prospective randomized study. J Hepatol. 1997 May;26(5):1034–1041. doi: 10.1016/s0168-8278(97)80112-2. [DOI] [PubMed] [Google Scholar]
  5. BAKER L. A., SMITH C., LIEBERMAN G. The natural history of esophageal varices; a study of 115 cirrhotic patients in whom varices were diagnosed prior to bleeding. Am J Med. 1959 Feb;26(2):228–237. doi: 10.1016/0002-9343(59)90311-0. [DOI] [PubMed] [Google Scholar]
  6. Bagarani M., Albertini V., Anzà M., Barlattani A., Bracci F., Cucchiara G., Gizzonio D., Grassini G., Mari T., Procacciante F. Effect of somatostatin in controlling bleeding from esophageal varices. Ital J Surg Sci. 1987;17(1):21–26. [PubMed] [Google Scholar]
  7. Barsoum M. S., Bolous F. I., El-Rooby A. A., Rizk-Allah M. A., Ibrahim A. S. Tamponade and injection sclerotherapy in the management of bleeding oesophageal varices. Br J Surg. 1982 Feb;69(2):76–78. doi: 10.1002/bjs.1800690206. [DOI] [PubMed] [Google Scholar]
  8. Beppu K., Inokuchi K., Koyanagi N., Nakayama S., Sakata H., Kitano S., Kobayashi M. Prediction of variceal hemorrhage by esophageal endoscopy. Gastrointest Endosc. 1981 Nov;27(4):213–218. doi: 10.1016/s0016-5107(81)73224-3. [DOI] [PubMed] [Google Scholar]
  9. Bernard B., Cadranel J. F., Valla D., Escolano S., Jarlier V., Opolon P. Prognostic significance of bacterial infection in bleeding cirrhotic patients: a prospective study. Gastroenterology. 1995 Jun;108(6):1828–1834. doi: 10.1016/0016-5085(95)90146-9. [DOI] [PubMed] [Google Scholar]
  10. Bernard B., Grangé J. D., Khac E. N., Amiot X., Opolon P., Poynard T. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology. 1999 Jun;29(6):1655–1661. doi: 10.1002/hep.510290608. [DOI] [PubMed] [Google Scholar]
  11. Blaise M., Pateron D., Trinchet J. C., Levacher S., Beaugrand M., Pourriat J. L. Systemic antibiotic therapy prevents bacterial infection in cirrhotic patients with gastrointestinal hemorrhage. Hepatology. 1994 Jul;20(1 Pt 1):34–38. doi: 10.1016/0270-9139(94)90131-7. [DOI] [PubMed] [Google Scholar]
  12. Bleichner G., Boulanger R., Squara P., Sollet J. P., Parent A. Frequency of infections in cirrhotic patients presenting with acute gastrointestinal haemorrhage. Br J Surg. 1986 Sep;73(9):724–726. doi: 10.1002/bjs.1800730916. [DOI] [PubMed] [Google Scholar]
  13. Bosch J., Groszmann R. J., García-Pagán J. C., Terés J., García-Tsao G., Navasa M., Mas A., Rodés J. Association of transdermal nitroglycerin to vasopressin infusion in the treatment of variceal hemorrhage: a placebo-controlled clinical trial. Hepatology. 1989 Dec;10(6):962–968. doi: 10.1002/hep.1840100612. [DOI] [PubMed] [Google Scholar]
  14. Bosch J., Kravetz D., Rodes J. Effects of somatostatin on hepatic and systemic hemodynamics in patients with cirrhosis of the liver: comparison with vasopressin. Gastroenterology. 1981 Mar;80(3):518–525. [PubMed] [Google Scholar]
  15. Burroughs A. K., Hamilton G., Phillips A., Mezzanotte G., McIntyre N., Hobbs K. E. A comparison of sclerotherapy with staple transection of the esophagus for the emergency control of bleeding from esophageal varices. N Engl J Med. 1989 Sep 28;321(13):857–862. doi: 10.1056/NEJM198909283211303. [DOI] [PubMed] [Google Scholar]
  16. Burroughs A. K., Jenkins W. J., Sherlock S., Dunk A., Walt R. P., Osuafor T. O., Mackie S., Dick R. Controlled trial of propranolol for the prevention of recurrent variceal hemorrhage in patients with cirrhosis. N Engl J Med. 1983 Dec 22;309(25):1539–1542. doi: 10.1056/NEJM198312223092502. [DOI] [PubMed] [Google Scholar]
  17. Burroughs A. K., McCormick P. A., Hughes M. D., Sprengers D., D'Heygere F., McIntyre N. Randomized, double-blind, placebo-controlled trial of somatostatin for variceal bleeding. Emergency control and prevention of early variceal rebleeding. Gastroenterology. 1990 Nov;99(5):1388–1395. doi: 10.1016/0016-5085(90)91166-4. [DOI] [PubMed] [Google Scholar]
  18. CONN H. O., LINDENMUTH W. W. PROPHYLACTIC PORTACAVAL ANASTOMOSIS IN CIRRHOTIC PATIENTS WITH ESOPHAGEAL VARICES: A PROGRESS REPORT OF A CONTINUING STUDY. N Engl J Med. 1965 Jun 17;272:1255–1263. doi: 10.1056/NEJM196506172722402. [DOI] [PubMed] [Google Scholar]
  19. Cabrera J., Maynar M., Granados R., Gorriz E., Reyes R., Pulido-Duque J. M., Rodriguez SanRoman J. L., Guerra C., Kravetz D. Transjugular intrahepatic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage. Gastroenterology. 1996 Mar;110(3):832–839. doi: 10.1053/gast.1996.v110.pm8608893. [DOI] [PubMed] [Google Scholar]
  20. Calès P., Pascal J. P. Histoire naturelle des varices oesophagiennes au cours de la cirrhose (de la naissance à la rupture). Gastroenterol Clin Biol. 1988 Mar;12(3):245–254. [PubMed] [Google Scholar]
  21. Cello J. P., Crass R., Trunkey D. D. Endoscopic sclerotherapy versus esophageal transection of Child's class C patients with variceal hemorrhage. Comparison with results of portacaval shunt: preliminary report. Surgery. 1982 Mar;91(3):333–338. [PubMed] [Google Scholar]
  22. Cello J. P., Grendell J. H., Crass R. A., Weber T. E., Trunkey D. D. Endoscopic sclerotherapy versus portacaval shunt in patient with severe cirrhosis and acute variceal hemorrhage. Long-term follow-up. N Engl J Med. 1987 Jan 1;316(1):11–15. doi: 10.1056/NEJM198701013160103. [DOI] [PubMed] [Google Scholar]
  23. Cello J. P., Ring E. J., Olcott E. W., Koch J., Gordon R., Sandhu J., Morgan D. R., Ostroff J. W., Rockey D. C., Bacchetti P. Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997 Jun 1;126(11):858–865. doi: 10.7326/0003-4819-126-11-199706010-00002. [DOI] [PubMed] [Google Scholar]
  24. Chiu K. W., Sheen I. S., Liaw Y. F. A controlled study of glypressin versus vasopressin in the control of bleeding from oesophageal varices. J Gastroenterol Hepatol. 1990 Sep-Oct;5(5):549–553. doi: 10.1111/j.1440-1746.1990.tb01439.x. [DOI] [PubMed] [Google Scholar]
  25. Christensen E., Fauerholdt L., Schlichting P., Juhl E., Poulsen H., Tygstrup N. Aspects of the natural history of gastrointestinal bleeding in cirrhosis and the effect of prednisone. Gastroenterology. 1981 Nov;81(5):944–952. [PubMed] [Google Scholar]
  26. Christensen E., Krintel J. J., Hansen S. M., Johansen J. K., Juhl E. Prognosis after the first episode of gastrointestinal bleeding or coma in cirrhosis. Survival and prognostic factors. Scand J Gastroenterol. 1989 Oct;24(8):999–1006. doi: 10.3109/00365528909089247. [DOI] [PubMed] [Google Scholar]
  27. Colombo M., de Franchis R., Tommasini M., Sangiovanni A., Dioguardi N. Beta-blockade prevents recurrent gastrointestinal bleeding in well-compensated patients with alcoholic cirrhosis: a multicenter randomized controlled trial. Hepatology. 1989 Mar;9(3):433–438. doi: 10.1002/hep.1840090315. [DOI] [PubMed] [Google Scholar]
  28. Conn H. O., Grace N. D., Bosch J., Groszmann R. J., Rodés J., Wright S. C., Matloff D. S., Garcia-Tsao G., Fisher R. L., Navasa M. Propranolol in the prevention of the first hemorrhage from esophagogastric varices: A multicenter, randomized clinical trial. The Boston-New Haven-Barcelona Portal Hypertension Study Group. Hepatology. 1991 May;13(5):902–912. [PubMed] [Google Scholar]
  29. Conn H. O., Ramsby G. R., Storer E. H., Mutchnick M. G., Joshi P. H., Phillips M. M., Cohen G. A., Fields G. N., Petroski D. Intraarterial vasopressin in the treatment of upper gastrointestinal hemorrhage: a prospective, controlled clinical trial. Gastroenterology. 1975 Feb;68(2):211–221. [PubMed] [Google Scholar]
  30. Czaja A. J., Wolf A. M., Summerskill W. H. Development and early prognosis of esophageal varices in severe chronic active liver disease (CALD) treated with prednisone. Gastroenterology. 1979 Oct;77(4 Pt 1):629–633. [PubMed] [Google Scholar]
  31. D'Amico G., Pagliaro L., Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology. 1995 Jul;22(1):332–354. doi: 10.1002/hep.1840220145. [DOI] [PubMed] [Google Scholar]
  32. D'Amico G., Traina M., Vizzini G., Tinè F., Politi F., Montalbano L., Luca A., Pasta L., Pagliaro L., Morabito A. Terlipressin or vasopressin plus transdermal nitroglycerin in a treatment strategy for digestive bleeding in cirrhosis. A randomized clinical trial. Liver Study Group of V. Cervello Hospital. J Hepatol. 1994 Feb;20(2):206–212. doi: 10.1016/s0168-8278(05)80059-5. [DOI] [PubMed] [Google Scholar]
  33. Dagradi A. E. The natural history of esophageal varices in patients with alcoholic liver cirrhosis. An endoscopic and clinical study. Am J Gastroenterol. 1972 Jun;57(6):520–540. [PubMed] [Google Scholar]
  34. Dasarathy S., Dwivedi M., Bhargava D. K., Sundaram K. R., Ramachandran K. A prospective randomized trial comparing repeated endoscopic sclerotherapy and propranolol in decompensated (Child class B and C) cirrhotic patients. Hepatology. 1992 Jul;16(1):89–94. doi: 10.1002/hep.1840160116. [DOI] [PubMed] [Google Scholar]
  35. Dawson J., Gertsch P., Mosimann F., West R., Elias E. Endoscopic variceal pressure measurements: response to isosorbide dinitrate. Gut. 1985 Aug;26(8):843–847. doi: 10.1136/gut.26.8.843. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. De Franchis R., Primignani M., Arcidiacono P. G., Rizzi P. M., Vitagliano P., Vazzoler M. C., Arcidiacono R., Rossi A., Zambelli A., Cosentino F. Prophylactic sclerotherapy in high-risk cirrhotics selected by endoscopic criteria. A multicenter randomized controlled trial. Gastroenterology. 1991 Oct;101(4):1087–1093. doi: 10.1016/0016-5085(91)90738-7. [DOI] [PubMed] [Google Scholar]
  37. Dollet J. M., Champigneulle B., Patris A., Bigard M. A., Gaucher P. Sclérothérapie endoscopique contre propranolol après hémorragie par rupture de varices oesophagiennes chez le cirrhotique. Résultats à 4 ans d'une étude randomisée. Gastroenterol Clin Biol. 1988 Mar;12(3):234–239. [PubMed] [Google Scholar]
  38. Eccles M., Clapp Z., Grimshaw J., Adams P. C., Higgins B., Purves I., Russell I. North of England evidence based guidelines development project: methods of guideline development. BMJ. 1996 Mar 23;312(7033):760–762. doi: 10.1136/bmj.312.7033.760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Feu F., Ruiz del Arbol L., Bañares R., Planas R., Bosch J. Double-blind randomized controlled trial comparing terlipressin and somatostatin for acute variceal hemorrhage. Variceal Bleeding Study Group. Gastroenterology. 1996 Nov;111(5):1291–1299. doi: 10.1053/gast.1996.v111.pm8898643. [DOI] [PubMed] [Google Scholar]
  40. Fischer J. E., Bower R. H., Atamian S., Welling R. Comparison of distal and proximal splenorenal shunts: a randomized prospective trial. Ann Surg. 1981 Oct;194(4):531–544. doi: 10.1097/00000658-198110000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Fleig W. E., Stange E. F., Hunecke R., Schönborn W., Hurler U., Rainer K., Gaus W., Ditschuneit H. Prevention of recurrent bleeding in cirrhotics with recent variceal hemorrhage: prospective, randomized comparison of propranolol and sclerotherapy. Hepatology. 1987 Mar-Apr;7(2):355–361. doi: 10.1002/hep.1840070224. [DOI] [PubMed] [Google Scholar]
  42. Fogel M. R., Knauer C. M., Andres L. L., Mahal A. S., Stein D. E., Kemeny M. J., Rinki M. M., Walker J. E., Siegmund D., Gregory P. B. Continuous intravenous vasopressin in active upper gastrointestinal bleeding. Ann Intern Med. 1982 May;96(5):565–569. doi: 10.7326/0003-4819-96-5-565. [DOI] [PubMed] [Google Scholar]
  43. Fort E., Sautereau D., Silvain C., Ingrand P., Pillegand B., Beauchant M. A randomized trial of terlipressin plus nitroglycerin vs. balloon tamponade in the control of acute variceal hemorrhage. Hepatology. 1990 Apr;11(4):678–681. doi: 10.1002/hep.1840110423. [DOI] [PubMed] [Google Scholar]
  44. Freeman J. G., Cobden I., Record C. O. Placebo-controlled trial of terlipressin (glypressin) in the management of acute variceal bleeding. J Clin Gastroenterol. 1989 Feb;11(1):58–60. doi: 10.1097/00004836-198902000-00014. [DOI] [PubMed] [Google Scholar]
  45. Garcia-Tsao G., Groszmann R. J., Fisher R. L., Conn H. O., Atterbury C. E., Glickman M. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology. 1985 May-Jun;5(3):419–424. doi: 10.1002/hep.1840050313. [DOI] [PubMed] [Google Scholar]
  46. García-Villarreal L., Martínez-Lagares F., Sierra A., Guevara C., Marrero J. M., Jiménez E., Monescillo A., Hernández-Cabrero T., Alonso J. M., Fuentes R. Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal rebleeding after recent variceal hemorrhage. Hepatology. 1999 Jan;29(1):27–32. doi: 10.1002/hep.510290125. [DOI] [PubMed] [Google Scholar]
  47. Garden O. J., Mills P. R., Birnie G. G., Murray G. D., Carter D. C. Propranolol in the prevention of recurrent variceal hemorrhage in cirrhotic patients. A controlled trial. Gastroenterology. 1990 Jan;98(1):185–190. doi: 10.1016/0016-5085(90)91308-s. [DOI] [PubMed] [Google Scholar]
  48. Garden O. J., Motyl H., Gilmour W. H., Utley R. J., Carter D. C. Prediction of outcome following acute variceal haemorrhage. Br J Surg. 1985 Feb;72(2):91–95. doi: 10.1002/bjs.1800720205. [DOI] [PubMed] [Google Scholar]
  49. Gatta A., Merkel C., Sacerdoti D., Bolognesi M., Caregaro L., Zuin R., Angeli P., Ruol A. Nadolol for prevention of variceal rebleeding in cirrhosis: a controlled clinical trial. Digestion. 1987;37(1):22–28. doi: 10.1159/000199483. [DOI] [PubMed] [Google Scholar]
  50. Gimson A. E., Ramage J. K., Panos M. Z., Hayllar K., Harrison P. M., Williams R., Westaby D. Randomised trial of variceal banding ligation versus injection sclerotherapy for bleeding oesophageal varices. Lancet. 1993 Aug 14;342(8868):391–394. doi: 10.1016/0140-6736(93)92812-8. [DOI] [PubMed] [Google Scholar]
  51. Gimson A. E., Westaby D., Hegarty J., Watson A., Williams R. A randomized trial of vasopressin and vasopressin plus nitroglycerin in the control of acute variceal hemorrhage. Hepatology. 1986 May-Jun;6(3):410–413. doi: 10.1002/hep.1840060314. [DOI] [PubMed] [Google Scholar]
  52. Gimson A. E., Westaby D., Williams R. Endoscopic sclerotherapy in the management of gastric variceal haemorrhage. J Hepatol. 1991 Nov;13(3):274–278. doi: 10.1016/0168-8278(91)90068-m. [DOI] [PubMed] [Google Scholar]
  53. Goulis J., Armonis A., Patch D., Sabin C., Greenslade L., Burroughs A. K. Bacterial infection is independently associated with failure to control bleeding in cirrhotic patients with gastrointestinal hemorrhage. Hepatology. 1998 May;27(5):1207–1212. doi: 10.1002/hep.510270504. [DOI] [PubMed] [Google Scholar]
  54. Grace N. D., Conn H. O., Resnick R. H., Groszmann R. J., Atterbury C. E., Wright S. C., Gusberg R. J., Vollman R., Garcia-Tsao G., Fisher R. L. Distal splenorenal vs. portal-systemic shunts after hemorrhage from varices: a randomized controlled trial. Hepatology. 1988 Nov-Dec;8(6):1475–1481. doi: 10.1002/hep.1840080602. [DOI] [PubMed] [Google Scholar]
  55. Graham D. Y., Smith J. L. The course of patients after variceal hemorrhage. Gastroenterology. 1981 Apr;80(4):800–809. [PubMed] [Google Scholar]
  56. Greig J. D., Garden O. J., Anderson J. R., Carter D. C. Management of gastric variceal haemorrhage. Br J Surg. 1990 Mar;77(3):297–299. doi: 10.1002/bjs.1800770318. [DOI] [PubMed] [Google Scholar]
  57. Grimshaw J., Eccles M., Russell I. Developing clinically valid practice guidelines. J Eval Clin Pract. 1995 Sep;1(1):37–48. doi: 10.1111/j.1365-2753.1995.tb00006.x. [DOI] [PubMed] [Google Scholar]
  58. Groszmann R. J., Bosch J., Grace N. D., Conn H. O., Garcia-Tsao G., Navasa M., Alberts J., Rodes J., Fischer R., Bermann M. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology. 1990 Nov;99(5):1401–1407. doi: 10.1016/0016-5085(90)91168-6. [DOI] [PubMed] [Google Scholar]
  59. Groszmann R. J., Kravetz D., Bosch J., Glickman M., Bruix J., Bredfeldt J., Conn H. O., Rodes J., Storer E. H. Nitroglycerin improves the hemodynamic response to vasopressin in portal hypertension. Hepatology. 1982 Nov-Dec;2(6):757–762. doi: 10.1002/hep.1840020602. [DOI] [PubMed] [Google Scholar]
  60. Harada T., Yoshida T., Shigemitsu T., Takeo Y., Tada M., Okita K. Therapeutic results of endoscopic variceal ligation for acute bleeding of oesophageal and gastric varices. J Gastroenterol Hepatol. 1997 Apr;12(4):331–335. doi: 10.1111/j.1440-1746.1997.tb00430.x. [DOI] [PubMed] [Google Scholar]
  61. Harley H. A., Morgan T., Redeker A. G., Reynolds T. B., Villamil F., Weiner J. M., Yellin A. Results of a randomized trial of end-to-side portacaval shunt and distal splenorenal shunt in alcoholic liver disease and variceal bleeding. Gastroenterology. 1986 Oct;91(4):802–809. doi: 10.1016/0016-5085(86)90679-7. [DOI] [PubMed] [Google Scholar]
  62. Hashizume M., Ohta M., Ueno K., Tanoue K., Kitano S., Sugimachi K. Endoscopic ligation of esophageal varices compared with injection sclerotherapy: a prospective randomized trial. Gastrointest Endosc. 1993 Mar-Apr;39(2):123–126. doi: 10.1016/s0016-5107(93)70050-4. [DOI] [PubMed] [Google Scholar]
  63. Hayes P. C., Davis J. M., Lewis J. A., Bouchier I. A. Meta-analysis of value of propranolol in prevention of variceal haemorrhage. Lancet. 1990 Jul 21;336(8708):153–156. doi: 10.1016/0140-6736(90)91668-z. [DOI] [PubMed] [Google Scholar]
  64. Henderson J. M., Kutner M. H., Millikan W. J., Jr, Galambos J. T., Riepe S. P., Brooks W. S., Bryan F. C., Warren W. D. Endoscopic variceal sclerosis compared with distal splenorenal shunt to prevent recurrent variceal bleeding in cirrhosis. A prospective, randomized trial. Ann Intern Med. 1990 Feb 15;112(4):262–269. doi: 10.7326/0003-4819-112-4-262. [DOI] [PubMed] [Google Scholar]
  65. Hou M. C., Lin H. C., Kuo B. I., Chen C. H., Lee F. Y., Lee S. D. Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial. Hepatology. 1995 Jun;21(6):1517–1522. [PubMed] [Google Scholar]
  66. Hsieh W. J., Lin H. C., Hwang S. J., Hou M. C., Lee F. Y., Chang F. Y., Lee S. D. The effect of ciprofloxacin in the prevention of bacterial infection in patients with cirrhosis after upper gastrointestinal bleeding. Am J Gastroenterol. 1998 Jun;93(6):962–966. doi: 10.1111/j.1572-0241.1998.00288.x. [DOI] [PubMed] [Google Scholar]
  67. Huizinga W. K., Angorn I. B., Baker L. W. Esophageal transection versus injection sclerotherapy in the management of bleeding esophageal varices in patients at high risk. Surg Gynecol Obstet. 1985 Jun;160(6):539–546. [PubMed] [Google Scholar]
  68. Idéo G., Bellati G., Fesce E., Grimoldi D. Nadolol can prevent the first gastrointestinal bleeding in cirrhotics: a prospective, randomized study. Hepatology. 1988 Jan-Feb;8(1):6–9. doi: 10.1002/hep.1840080103. [DOI] [PubMed] [Google Scholar]
  69. Inokuchi K. Improved survival after prophylactic portal nondecompression surgery for esophageal varices: a randomized clinical trial. Cooperative Study Group of Portal Hypertension of Japan. Hepatology. 1990 Jul;12(1):1–6. doi: 10.1002/hep.1840120102. [DOI] [PubMed] [Google Scholar]
  70. Jackson F. C., Perrin E. B., Felix W. R., Smith A. G. A clinical investigation of the portacaval shunt. V. Survival analysis of the therapeutic operation. Ann Surg. 1971 Oct;174(4):672–701. doi: 10.1097/00000658-197110000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Jackson F. C., Perrin E. B., Smith A. G., Dagradi A. E., Nadal H. M. A clinical investigation of the portacaval shunt. II. Survival analysis of the prophylactic operation. Am J Surg. 1968 Jan;115(1):22–42. doi: 10.1016/0002-9610(68)90127-x. [DOI] [PubMed] [Google Scholar]
  72. Jalan R., Forrest E. H., Stanley A. J., Redhead D. N., Forbes J., Dillon J. F., MacGilchrist A. J., Finlayson N. D., Hayes P. C. A randomized trial comparing transjugular intrahepatic portosystemic stent-shunt with variceal band ligation in the prevention of rebleeding from esophageal varices. Hepatology. 1997 Nov;26(5):1115–1122. doi: 10.1002/hep.510260505. [DOI] [PubMed] [Google Scholar]
  73. Jalan R., John T. G., Redhead D. N., Garden O. J., Simpson K. J., Finlayson N. D., Hayes P. C. A comparative study of emergency transjugular intrahepatic portosystemic stent-shunt and esophageal transection in the management of uncontrolled variceal hemorrhage. Am J Gastroenterol. 1995 Nov;90(11):1932–1937. [PubMed] [Google Scholar]
  74. Jaramillo J. L., de la Mata M., Miño G., Costán G., Gómez-Camacho F. Somatostatin versus Sengstaken balloon tamponade for primary haemostasia of bleeding esophageal varices. A randomized pilot study. J Hepatol. 1991 Jan;12(1):100–105. doi: 10.1016/0168-8278(91)90917-z. [DOI] [PubMed] [Google Scholar]
  75. Jenkins S. A., Baxter J. N., Corbett W., Devitt P., Ware J., Shields R. A prospective randomised controlled clinical trial comparing somatostatin and vasopressin in controlling acute variceal haemorrhage. Br Med J (Clin Res Ed) 1985 Jan 26;290(6464):275–278. doi: 10.1136/bmj.290.6464.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  76. Kanagawa H., Mima S., Kouyama H., Gotoh K., Uchida T., Okuda K. Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration. J Gastroenterol Hepatol. 1996 Jan;11(1):51–58. doi: 10.1111/j.1440-1746.1996.tb00010.x. [DOI] [PubMed] [Google Scholar]
  77. Kobe E., Zipprich B., Schentke K. U., Nilius R. Prophylactic endoscopic sclerotherapy of esophageal varices--a prospective randomized trial. Endoscopy. 1990 Nov;22(6):245–248. doi: 10.1055/s-2007-1012862. [DOI] [PubMed] [Google Scholar]
  78. Koch H., Henning H., Grimm H., Soehendra N. Prophylactic sclerosing of esophageal varices--results of a prospective controlled study. Endoscopy. 1986 Mar;18(2):40–43. doi: 10.1055/s-2007-1018322. [DOI] [PubMed] [Google Scholar]
  79. Koito K., Namieno T., Nagakawa T., Morita K. Balloon-occluded retrograde transvenous obliteration for gastric varices with gastrorenal or gastrocaval collaterals. AJR Am J Roentgenol. 1996 Nov;167(5):1317–1320. doi: 10.2214/ajr.167.5.8911204. [DOI] [PubMed] [Google Scholar]
  80. Korula J., Balart L. A., Radvan G., Zweiban B. E., Larson A. W., Kao H. W., Yamada S. A prospective, randomized controlled trial of chronic esophageal variceal sclerotherapy. Hepatology. 1985 Jul-Aug;5(4):584–589. doi: 10.1002/hep.1840050410. [DOI] [PubMed] [Google Scholar]
  81. Kravetz D., Bosch J., Terés J., Bruix J., Rimola A., Rodés J. Comparison of intravenous somatostatin and vasopressin infusions in treatment of acute variceal hemorrhage. Hepatology. 1984 May-Jun;4(3):442–446. doi: 10.1002/hep.1840040315. [DOI] [PubMed] [Google Scholar]
  82. Kuradusenge P., Rousseau H., Vinel J. P., Maquin P., Croizet O., Coustet B., Railhac J. J., Joffre F., Pascal J. P. Traitement des hémorragies par rupture de varices cardio-tubérositaires par anastomose porto-systémique intra-hépatique par voie trans-jugulaire. Gastroenterol Clin Biol. 1993;17(6-7):431–434. [PubMed] [Google Scholar]
  83. Laine L., el-Newihi H. M., Migikovsky B., Sloane R., Garcia F. Endoscopic ligation compared with sclerotherapy for the treatment of bleeding esophageal varices. Ann Intern Med. 1993 Jul 1;119(1):1–7. doi: 10.7326/0003-4819-119-1-199307010-00001. [DOI] [PubMed] [Google Scholar]
  84. Langer B., Taylor B. R., Mackenzie D. R., Gilas T., Stone R. M., Blendis L. Further report of a prospective randomized trial comparing distal splenorenal shunt with end-to-side portacaval shunt. An analysis of encephalopathy, survival, and quality of life. Gastroenterology. 1985 Feb;88(2):424–429. doi: 10.1016/0016-5085(85)90502-5. [DOI] [PubMed] [Google Scholar]
  85. Larson A. W., Cohen H., Zweiban B., Chapman D., Gourdji M., Korula J., Weiner J. Acute esophageal variceal sclerotherapy. Results of a prospective randomized controlled trial. JAMA. 1986 Jan 24;255(4):497–500. [PubMed] [Google Scholar]
  86. Lay C. S., Tsai Y. T., Teg C. Y., Shyu W. S., Guo W. S., Wu K. L., Lo K. J. Endoscopic variceal ligation in prophylaxis of first variceal bleeding in cirrhotic patients with high-risk esophageal varices. Hepatology. 1997 Jun;25(6):1346–1350. doi: 10.1002/hep.510250608. [DOI] [PubMed] [Google Scholar]
  87. Lebrec D., De Fleury P., Rueff B., Nahum H., Benhamou J. P. Portal hypertension, size of esophageal varices, and risk of gastrointestinal bleeding in alcoholic cirrhosis. Gastroenterology. 1980 Dec;79(6):1139–1144. [PubMed] [Google Scholar]
  88. Lebrec D., Poynard T., Bernuau J., Bercoff E., Nouel O., Capron J. P., Poupon R., Bouvry M., Rueff B., Benhamou J. P. A randomized controlled study of propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a final report. Hepatology. 1984 May-Jun;4(3):355–358. doi: 10.1002/hep.1840040301. [DOI] [PubMed] [Google Scholar]
  89. Lebrec D., Poynard T., Capron J. P., Hillon P., Geoffroy P., Roulot D., Chaput J. C., Rueff B., Benhamou J. P. Nadolol for prophylaxis of gastrointestinal bleeding in patients with cirrhosis. A randomized trial. J Hepatol. 1988 Aug;7(1):118–125. doi: 10.1016/s0168-8278(88)80515-4. [DOI] [PubMed] [Google Scholar]
  90. Lo G. H., Lai K. H., Cheng J. S., Hwu J. H., Chang C. F., Chen S. M., Chiang H. T. A prospective, randomized trial of sclerotherapy versus ligation in the management of bleeding esophageal varices. Hepatology. 1995 Aug;22(2):466–471. [PubMed] [Google Scholar]
  91. MERIGAN T. C., Jr, PLOTKIN G. R., DAVIDSON C. S. Effect of intravenously administered posterior pituitary extract on hemorrhage from bleeding esophageal varices. A controlled evaluation. N Engl J Med. 1962 Jan 18;266:134–135. doi: 10.1056/NEJM196201182660307. [DOI] [PubMed] [Google Scholar]
  92. MacDougall B. R., Westaby D., Theodossi A., Dawson J. L., Williams R. Increased long-term survival in variceal haemorrhage using injection sclerotherapy. Results of a controlled trial. Lancet. 1982 Jan 16;1(8264):124–127. doi: 10.1016/s0140-6736(82)90378-6. [DOI] [PubMed] [Google Scholar]
  93. Mallory A., Schaefer J. W., Cohen J. R., Holt S. A., Norton L. W. Selective intra-arterial vasopression in fusion for upper gastrointestinal tract hemorrhage: a controlled trial. Arch Surg. 1980 Jan;115(1):30–32. doi: 10.1001/archsurg.1980.01380010022004. [DOI] [PubMed] [Google Scholar]
  94. Martin T., Taupignon A., Lavignolle A., Perrin D., Le Bodic L. Prévention des récidives hémorragiques chez des malades atteints de cirrhose. Résultats d'une étude contrôlée comparant propranolol et sclérose endoscopique. Gastroenterol Clin Biol. 1991;15(11):833–837. [PubMed] [Google Scholar]
  95. McCormick P. A., Dick R., Panagou E. B., Chin J. K., Greenslade L., McIntyre N., Burroughs A. K. Emergency transjugular intrahepatic portasystemic stent shunting as salvage treatment for uncontrolled variceal bleeding. Br J Surg. 1994 Sep;81(9):1324–1327. doi: 10.1002/bjs.1800810922. [DOI] [PubMed] [Google Scholar]
  96. McKee R. A study of octreotide in oesophageal varices. Digestion. 1990;45 (Suppl 1):60–65. doi: 10.1159/000200264. [DOI] [PubMed] [Google Scholar]
  97. Merkel C., Bolognesi M., Bellon S., Zuin R., Noventa F., Finucci G., Sacerdoti D., Angeli P., Gatta A. Prognostic usefulness of hepatic vein catheterization in patients with cirrhosis and esophageal varices. Gastroenterology. 1992 Mar;102(3):973–979. doi: 10.1016/0016-5085(92)90185-2. [DOI] [PubMed] [Google Scholar]
  98. Merli M., Salerno F., Riggio O., de Franchis R., Fiaccadori F., Meddi P., Primignani M., Pedretti G., Maggi A., Capocaccia L. Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal bleeding in cirrhosis: a randomized multicenter trial. Gruppo Italiano Studio TIPS (G.I.S.T.). Hepatology. 1998 Jan;27(1):48–53. doi: 10.1002/hep.510270109. [DOI] [PubMed] [Google Scholar]
  99. Millikan W. J., Jr, Warren W. D., Henderson J. M., Smith R. B., 3rd, Salam A. A., Galambos J. T., Kutner M. H., Keen J. H. The Emory prospective randomized trial: selective versus nonselective shunt to control variceal bleeding. Ten year follow-up. Ann Surg. 1985 Jun;201(6):712–722. doi: 10.1097/00000658-198506000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  100. Minocha A., Richards R. J. Sengstaken-Blakemore tube for control of massive bleeding from gastric varices in hiatal hernia. J Clin Gastroenterol. 1992 Jan;14(1):36–38. doi: 10.1097/00004836-199201000-00009. [DOI] [PubMed] [Google Scholar]
  101. Moretó M., Zaballa M., Bernal A., Ibáez S., Ojembarrena E., Rodriguez A. A randomized trial of tamponade or sclerotherapy as immediate treatment for bleeding esophageal varices. Surg Gynecol Obstet. 1988 Oct;167(4):331–334. [PubMed] [Google Scholar]
  102. Navasa M., Chesta J., Bosch J., Rodés J. Reduction of portal pressure by isosorbide-5-mononitrate in patients with cirrhosis. Effects on splanchnic and systemic hemodynamics and liver function. Gastroenterology. 1989 Apr;96(4):1110–1118. doi: 10.1016/0016-5085(89)91630-2. [DOI] [PubMed] [Google Scholar]
  103. Oho K., Iwao T., Sumino M., Toyonaga A., Tanikawa K. Ethanolamine oleate versus butyl cyanoacrylate for bleeding gastric varices: a nonrandomized study. Endoscopy. 1995 Jun;27(5):349–354. doi: 10.1055/s-2007-1005712. [DOI] [PubMed] [Google Scholar]
  104. PALMER E. D., BRICK I. B. Correlation between the severity of esophageal varices in portal cirrhosis and their propensity toward hemorrhage. Gastroenterology. 1956 Jan;30(1):85–90. [PubMed] [Google Scholar]
  105. Panés J., Terés J., Bosch J., Rodés J. Efficacy of balloon tamponade in treatment of bleeding gastric and esophageal varices. Results in 151 consecutive episodes. Dig Dis Sci. 1988 Apr;33(4):454–459. doi: 10.1007/BF01536031. [DOI] [PubMed] [Google Scholar]
  106. Papatheodoridis G. V., Goulis J., Leandro G., Patch D., Burroughs A. K. Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: A meta-analysis. Hepatology. 1999 Sep;30(3):612–622. doi: 10.1002/hep.510300316. [DOI] [PubMed] [Google Scholar]
  107. Paquet K. J., Feussner H. Endoscopic sclerosis and esophageal balloon tamponade in acute hemorrhage from esophagogastric varices: a prospective controlled randomized trial. Hepatology. 1985 Jul-Aug;5(4):580–583. doi: 10.1002/hep.1840050409. [DOI] [PubMed] [Google Scholar]
  108. Paquet K. J., Koussouris P. Is there an indication for prophylactic endoscopic paravariceal injection sclerotherapy in patients with liver cirrhosis and portal hypertension? Endoscopy. 1986 May;18 (Suppl 2):32–35. doi: 10.1055/s-2007-1018424. [DOI] [PubMed] [Google Scholar]
  109. Pascal J. P., Cales P. Propranolol in the prevention of first upper gastrointestinal tract hemorrhage in patients with cirrhosis of the liver and esophageal varices. N Engl J Med. 1987 Oct 1;317(14):856–861. doi: 10.1056/NEJM198710013171403. [DOI] [PubMed] [Google Scholar]
  110. Pauwels A., Mostefa-Kara N., Debenes B., Degoutte E., Lévy V. G. Systemic antibiotic prophylaxis after gastrointestinal hemorrhage in cirrhotic patients with a high risk of infection. Hepatology. 1996 Oct;24(4):802–806. doi: 10.1002/hep.510240408. [DOI] [PubMed] [Google Scholar]
  111. Piai G., Cipolletta L., Claar M., Marone G., Bianco M. A., Forte G., Iodice G., Mattera D., Minieri M., Rocco P. Prophylactic sclerotherapy of high-risk esophageal varices: results of a multicentric prospective controlled trial. Hepatology. 1988 Nov-Dec;8(6):1495–1500. doi: 10.1002/hep.1840080605. [DOI] [PubMed] [Google Scholar]
  112. Planas R., Boix J., Broggi M., Cabré E., Gomes-Vieira M. C., Morillas R., Armengol M., De León R., Humbert P., Salvá J. A. Portacaval shunt versus endoscopic sclerotherapy in the elective treatment of variceal hemorrhage. Gastroenterology. 1991 Apr;100(4):1078–1086. doi: 10.1016/0016-5085(91)90285-s. [DOI] [PubMed] [Google Scholar]
  113. Planas R., Quer J. C., Boix J., Canet J., Armengol M., Cabre E., Pintanel T., Humbert P., Oller B., Broggi M. A. A prospective randomized trial comparing somatostatin and sclerotherapy in the treatment of acute variceal bleeding. Hepatology. 1994 Aug;20(2):370–375. [PubMed] [Google Scholar]
  114. Polio J., Groszmann R. J. Hemodynamic factors involved in the development and rupture of esophageal varices: a pathophysiologic approach to treatment. Semin Liver Dis. 1986 Nov;6(4):318–331. doi: 10.1055/s-2008-1040614. [DOI] [PubMed] [Google Scholar]
  115. Pugh R. N., Murray-Lyon I. M., Dawson J. L., Pietroni M. C., Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646–649. doi: 10.1002/bjs.1800600817. [DOI] [PubMed] [Google Scholar]
  116. Pötzi R., Bauer P., Reichel W., Kerstan E., Renner F., Gangl A. Prophylactic endoscopic sclerotherapy of oesophageal varices in liver cirrhosis. A multicentre prospective controlled randomised trial in Vienna. Gut. 1989 Jun;30(6):873–879. doi: 10.1136/gut.30.6.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  117. Queuniet A. M., Czernichow P., Lerebours E., Ducrotte P., Tranvouez J. L., Colin R. Etude contrôlée du propranolol dans la prévention des récidives hémorragiques chez les patients cirrhotiques. Gastroenterol Clin Biol. 1987 Jan;11(1):41–47. [PubMed] [Google Scholar]
  118. Ramond M. J., Valla D., Mosnier J. F., Degott C., Bernuau J., Rueff B., Benhamou J. P. Successful endoscopic obturation of gastric varices with butyl cyanoacrylate. Hepatology. 1989 Oct;10(4):488–493. doi: 10.1002/hep.1840100415. [DOI] [PubMed] [Google Scholar]
  119. Reichle F. A., Fahmy W. F., Golsorkhi M. Prospective comparative clinical trial with distal splenorenal and mesocaval shunts. Am J Surg. 1979 Jan;137(1):13–21. doi: 10.1016/0002-9610(79)90004-7. [DOI] [PubMed] [Google Scholar]
  120. Resnick R. H., Chalmers T. C., Ishihara A. M., Garceau A. J., Callow A. D., Schimmel E. M., O'Hara E. T. A controlled study of the prophylactic portacaval shunt. A final report. Ann Intern Med. 1969 Apr;70(4):675–688. doi: 10.7326/0003-4819-70-4-675. [DOI] [PubMed] [Google Scholar]
  121. Resnick R. H., Iber F. L., Ishihara A. M., Chalmers T. C., Zimmerman H. A controlled study of the therapeutic portacaval shunt. Gastroenterology. 1974 Nov;67(5):843–857. [PubMed] [Google Scholar]
  122. Reynolds T. B., Donovan A. J., Mikkelsen W. P., Redeker A. G., Turrill F. L., Weiner J. M. Results of a 12-year randomized trial of portacaval shunt in patients with alcoholic liver disease and bleeding varices. Gastroenterology. 1981 May;80(5 Pt 1):1005–1011. [PubMed] [Google Scholar]
  123. Riemenschneider T., Bermel R. E., Hirner A. Ergebnisse der Devaskularisationsoperation des gastroösophagealen Uberganges bei Rezidivblutungen aus Osophagus- und Fundusvarizen. Zentralbl Chir. 1994;119(5):291–297. [PubMed] [Google Scholar]
  124. Rikkers L. F., Burnett D. A., Volentine G. D., Buchi K. N., Cormier R. A. Shunt surgery versus endoscopic sclerotherapy for long-term treatment of variceal bleeding. Early results of a randomized trial. Ann Surg. 1987 Sep;206(3):261–271. doi: 10.1097/00000658-198709000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  125. Rimola A., Bory F., Teres J., Perez-Ayuso R. M., Arroyo V., Rodes J. Oral, nonabsorbable antibiotics prevent infection in cirrhotics with gastrointestinal hemorrhage. Hepatology. 1985 May-Jun;5(3):463–467. doi: 10.1002/hep.1840050320. [DOI] [PubMed] [Google Scholar]
  126. Rosemurgy A. S., Goode S. E., Zwiebel B. R., Black T. J., Brady P. G. A prospective trial of transjugular intrahepatic portasystemic stent shunts versus small-diameter prosthetic H-graft portacaval shunts in the treatment of bleeding varices. Ann Surg. 1996 Sep;224(3):378–386. doi: 10.1097/00000658-199609000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  127. Rossi V., Calès P., Burtin P., Charneau J., Person B., Pujol P., Valentin S., D'Aubigny N., Joubaud F., Boyer J. Prevention of recurrent variceal bleeding in alcoholic cirrhotic patients: prospective controlled trial of propranolol and sclerotherapy. J Hepatol. 1991 May;12(3):283–289. doi: 10.1016/0168-8278(91)90828-y. [DOI] [PubMed] [Google Scholar]
  128. Russo A., Giannone G., Magnano A., Passanisi G., Longo C. Prophylactic sclerotherapy in nonalcoholic liver cirrhosis: preliminary results of a prospective controlled randomized trial. World J Surg. 1989 Mar-Apr;13(2):149–153. doi: 10.1007/BF01658391. [DOI] [PubMed] [Google Scholar]
  129. Russo M. W., Zacks S. L., Sandler R. S., Brown R. S. Cost-effectiveness analysis of transjugular intrahepatic portosystemic shunt (TIPS) versus endoscopic therapy for the prevention of recurrent esophageal variceal bleeding. Hepatology. 2000 Feb;31(2):358–363. doi: 10.1002/hep.510310215. [DOI] [PubMed] [Google Scholar]
  130. Rössle M., Deibert P., Haag K., Ochs A., Olschewski M., Siegerstetter V., Hauenstein K. H., Geiger R., Stiepak C., Keller W. Randomised trial of transjugular-intrahepatic-portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding. Lancet. 1997 Apr 12;349(9058):1043–1049. doi: 10.1016/s0140-6736(96)08189-5. [DOI] [PubMed] [Google Scholar]
  131. Saari A., Klvilaakso E., Inberg M., Päkkönen M., Lahtinen J., Höckerstedt K., Schröder T. Comparison of somatostatin and vasopressin in bleeding esophageal varices. Am J Gastroenterol. 1990 Jul;85(7):804–807. [PubMed] [Google Scholar]
  132. Santangelo W. C., Dueno M. I., Estes B. L., Krejs G. J. Prophylactic sclerotherapy of large esophageal varices. N Engl J Med. 1988 Mar 31;318(13):814–818. doi: 10.1056/NEJM198803313181304. [DOI] [PubMed] [Google Scholar]
  133. Sanyal A. J., Freedman A. M., Luketic V. A., Purdum P. P., 3rd, Shiffman M. L., Cole P. E., Tisnado J., Simmons S. Transjugular intrahepatic portosystemic shunts compared with endoscopic sclerotherapy for the prevention of recurrent variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997 Jun 1;126(11):849–857. doi: 10.7326/0003-4819-126-11-199706010-00001. [DOI] [PubMed] [Google Scholar]
  134. Sanyal A. J., Freedman A. M., Luketic V. A., Purdum P. P., Shiffman M. L., Tisnado J., Cole P. E. Transjugular intrahepatic portosystemic shunts for patients with active variceal hemorrhage unresponsive to sclerotherapy. Gastroenterology. 1996 Jul;111(1):138–146. doi: 10.1053/gast.1996.v111.pm8698192. [DOI] [PubMed] [Google Scholar]
  135. Sarin S. K., Guptan R. K., Jain A. K., Sundaram K. R. A randomized controlled trial of endoscopic variceal band ligation for primary prophylaxis of variceal bleeding. Eur J Gastroenterol Hepatol. 1996 Apr;8(4):337–342. doi: 10.1097/00042737-199604000-00010. [DOI] [PubMed] [Google Scholar]
  136. Sarin S. K., Lahoti D., Saxena S. P., Murthy N. S., Makwana U. K. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatology. 1992 Dec;16(6):1343–1349. doi: 10.1002/hep.1840160607. [DOI] [PubMed] [Google Scholar]
  137. Sarin S. K., Lamba G. S., Kumar M., Misra A., Murthy N. S. Comparison of endoscopic ligation and propranolol for the primary prevention of variceal bleeding. N Engl J Med. 1999 Apr 1;340(13):988–993. doi: 10.1056/NEJM199904013401302. [DOI] [PubMed] [Google Scholar]
  138. Sarin S. K. Long-term follow-up of gastric variceal sclerotherapy: an eleven-year experience. Gastrointest Endosc. 1997 Jul;46(1):8–14. doi: 10.1016/s0016-5107(97)70202-5. [DOI] [PubMed] [Google Scholar]
  139. Sauer P., Theilmann L., Stremmel W., Benz C., Richter G. M., Stiehl A. Transjugular intrahepatic portosystemic stent shunt versus sclerotherapy plus propranolol for variceal rebleeding. Gastroenterology. 1997 Nov;113(5):1623–1631. doi: 10.1053/gast.1997.v113.pm9352865. [DOI] [PubMed] [Google Scholar]
  140. Sauerbruch T., Wotzka R., Köpcke W., Härlin M., Heldwein W., Bayerdörffer E., Sander R., Ansari H., Starz I., Paumgartner G. Prophylactic sclerotherapy before the first episode of variceal hemorrhage in patients with cirrhosis. N Engl J Med. 1988 Jul 7;319(1):8–15. doi: 10.1056/NEJM198807073190102. [DOI] [PubMed] [Google Scholar]
  141. Sheen I. S., Chen T. Y., Liaw Y. F. Randomized controlled study of propranolol for prevention of recurrent esophageal varices bleeding in patients with cirrhosis. Liver. 1989 Feb;9(1):1–5. doi: 10.1111/j.1600-0676.1989.tb00370.x. [DOI] [PubMed] [Google Scholar]
  142. Shields R., Jenkins S. A., Baxter J. N., Kingsnorth A. N., Ellenbogen S., Makin C. A., Gilmore I., Morris A. I., Ashby D., West C. R. A prospective randomised controlled trial comparing the efficacy of somatostatin with injection sclerotherapy in the control of bleeding oesophageal varices. J Hepatol. 1992 Sep;16(1-2):128–137. doi: 10.1016/s0168-8278(05)80105-9. [DOI] [PubMed] [Google Scholar]
  143. Silvain C., Carpentier S., Sautereau D., Czernichow B., Métreau J. M., Fort E., Ingrand P., Boyer J., Pillegand B., Doffël M. Terlipressin plus transdermal nitroglycerin vs. octreotide in the control of acute bleeding from esophageal varices: a multicenter randomized trial. Hepatology. 1993 Jul;18(1):61–65. [PubMed] [Google Scholar]
  144. Siringo S., McCormick P. A., Mistry P., Kaye G., McIntyre N., Burroughs A. K. Prognostic significance of the white nipple sign in variceal bleeding. Gastrointest Endosc. 1991 Jan-Feb;37(1):51–55. doi: 10.1016/s0016-5107(91)70621-4. [DOI] [PubMed] [Google Scholar]
  145. Soehendra N., Grimm H., Nam V. C., Berger B. N-butyl-2-cyanoacrylate: a supplement to endoscopic sclerotherapy. Endoscopy. 1987 Nov;19(6):221–224. doi: 10.1055/s-2007-1018288. [DOI] [PubMed] [Google Scholar]
  146. Soriano G., Guarner C., Tomás A., Villanueva C., Torras X., González D., Sainz S., Anguera A., Cussó X., Balanzó J. Norfloxacin prevents bacterial infection in cirrhotics with gastrointestinal hemorrhage. Gastroenterology. 1992 Oct;103(4):1267–1272. doi: 10.1016/0016-5085(92)91514-5. [DOI] [PubMed] [Google Scholar]
  147. Spina G. P., Santambrogio R., Opocher E., Cosentino F., Zambelli A., Passoni G. R., Cucchiaro G., Macrì M., Morandi E., Bruno S. Distal splenorenal shunt versus endoscopic sclerotherapy in the prevention of variceal rebleeding. First stage of a randomized, controlled trial. Ann Surg. 1990 Feb;211(2):178–186. doi: 10.1097/00000658-199002000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  148. Stanley A. J., Jalan R., Ireland H. M., Redhead D. N., Bouchier I. A., Hayes P. C. A comparison between gastric and oesophageal variceal haemorrhage treated with transjugular intrahepatic portosystemic stent shunt (TIPSS). Aliment Pharmacol Ther. 1997 Feb;11(1):171–176. doi: 10.1046/j.1365-2036.1997.106277000.x. [DOI] [PubMed] [Google Scholar]
  149. Stiegmann G. V., Goff J. S., Michaletz-Onody P. A., Korula J., Lieberman D., Saeed Z. A., Reveille R. M., Sun J. H., Lowenstein S. R. Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices. N Engl J Med. 1992 Jun 4;326(23):1527–1532. doi: 10.1056/NEJM199206043262304. [DOI] [PubMed] [Google Scholar]
  150. Sung J. J., Chung S. C., Lai C. W., Chan F. K., Leung J. W., Yung M. Y., Kassianides C., Li A. K. Octreotide infusion or emergency sclerotherapy for variceal haemorrhage. Lancet. 1993 Sep 11;342(8872):637–641. doi: 10.1016/0140-6736(93)91758-e. [DOI] [PubMed] [Google Scholar]
  151. Söderlund C., Ihre T. Endoscopic sclerotherapy v. conservative management of bleeding oesophageal varices. A 5-year prospective controlled trial of emergency and long-term treatment. Acta Chir Scand. 1985;151(5):449–456. [PubMed] [Google Scholar]
  152. Söderlund C., Magnusson I., Törngren S., Lundell L. Terlipressin (triglycyl-lysine vasopressin) controls acute bleeding oesophageal varices. A double-blind, randomized, placebo-controlled trial. Scand J Gastroenterol. 1990 Jun;25(6):622–630. doi: 10.3109/00365529009095539. [DOI] [PubMed] [Google Scholar]
  153. Takeuchi M., Nakai Y., Syu A., Okamoto E., Fujimoto J. Endoscopic ligation of gastric varices. Lancet. 1996 Oct 12;348(9033):1038–1038. doi: 10.1016/S0140-6736(05)64972-0. [DOI] [PubMed] [Google Scholar]
  154. Terblanche J., Bornman P. C., Kahn D., Jonker M. A., Campbell J. A., Wright J., Kirsch R. Failure of repeated injection sclerotherapy to improve long-term survival after oesophageal variceal bleeding. A five-year prospective controlled clinical trial. Lancet. 1983 Dec 10;2(8363):1328–1332. doi: 10.1016/s0140-6736(83)91090-5. [DOI] [PubMed] [Google Scholar]
  155. Terés J., Baroni R., Bordas J. M., Visa J., Pera C., Rodés J. Randomized trial of portacaval shunt, stapling transection and endoscopic sclerotherapy in uncontrolled variceal bleeding. J Hepatol. 1987 Apr;4(2):159–167. doi: 10.1016/s0168-8278(87)80075-2. [DOI] [PubMed] [Google Scholar]
  156. Terés J., Bordas J. M., Bravo D., Visa J., Grande L., Garcia-Valdecasas J. C., Pera C., Rodés J. Sclerotherapy vs. distal splenorenal shunt in the elective treatment of variceal hemorrhage: a randomized controlled trial. Hepatology. 1987 May-Jun;7(3):430–436. doi: 10.1002/hep.1840070303. [DOI] [PubMed] [Google Scholar]
  157. Terés J., Bosch J., Bordas J. M., Garcia Pagán J. C., Feu F., Cirera I., Rodés J. Propranolol versus sclerotherapy in preventing variceal rebleeding: a randomized controlled trial. Gastroenterology. 1993 Nov;105(5):1508–1514. doi: 10.1016/0016-5085(93)90158-9. [DOI] [PubMed] [Google Scholar]
  158. Thomas P. G., D'Cruz A. J. Distal splenorenal shunting for bleeding gastric varices. Br J Surg. 1994 Feb;81(2):241–244. doi: 10.1002/bjs.1800810227. [DOI] [PubMed] [Google Scholar]
  159. Triger D. R., Smart H. L., Hosking S. W., Johnson A. G. Prophylactic sclerotherapy for esophageal varices: long-term results of a single-center trial. Hepatology. 1991 Jan;13(1):117–123. [PubMed] [Google Scholar]
  160. Trudeau W., Prindiville T. Endoscopic injection sclerosis in bleeding gastric varices. Gastrointest Endosc. 1986 Aug;32(4):264–268. doi: 10.1016/s0016-5107(86)71843-9. [DOI] [PubMed] [Google Scholar]
  161. Tsai Y. T., Lay C. S., Lai K. H., Ng W. W., Yeh Y. S., Wang J. Y., Chiang T. T., Lee S. D., Chiang B. N., Lo K. J. Controlled trial of vasopressin plus nitroglycerin vs. vasopressin alone in the treatment of bleeding esophageal varices. Hepatology. 1986 May-Jun;6(3):406–409. doi: 10.1002/hep.1840060313. [DOI] [PubMed] [Google Scholar]
  162. Valenzuela J. E., Schubert T., Fogel M. R., Strong R. M., Levine J., Mills P. R., Fabry T. L., Taylor L. W., Conn H. O., Posillico J. T. A multicenter, randomized, double-blind trial of somatostatin in the management of acute hemorrhage from esophageal varices. Hepatology. 1989 Dec;10(6):958–961. doi: 10.1002/hep.1840100611. [DOI] [PubMed] [Google Scholar]
  163. Van Stiegmann G., Goff J. S. Endoscopic esophageal varix ligation: preliminary clinical experience. Gastrointest Endosc. 1988 Mar-Apr;34(2):113–117. doi: 10.1016/s0016-5107(88)71274-2. [DOI] [PubMed] [Google Scholar]
  164. Villanueva C., Balanzó J., Novella M. T., Soriano G., Sáinz S., Torras X., Cussó X., Guarner C., Vilardell F. Nadolol plus isosorbide mononitrate compared with sclerotherapy for the prevention of variceal rebleeding. N Engl J Med. 1996 Jun 20;334(25):1624–1629. doi: 10.1056/NEJM199606203342502. [DOI] [PubMed] [Google Scholar]
  165. Villeneuve J. P., Pomier-Layrargues G., Infante-Rivard C., Willems B., Huet P. M., Marleau D., Viallet A. Propranolol for the prevention of recurrent variceal hemorrhage: a controlled trial. Hepatology. 1986 Nov-Dec;6(6):1239–1243. doi: 10.1002/hep.1840060602. [DOI] [PubMed] [Google Scholar]
  166. Vinel J. P., Cassigneul J., Levade M., Voigt J. J., Pascal J. P. Assessment of short-term prognosis after variceal bleeding in patients with alcoholic cirrhosis by early measurement of portohepatic gradient. Hepatology. 1986 Jan-Feb;6(1):116–117. doi: 10.1002/hep.1840060122. [DOI] [PubMed] [Google Scholar]
  167. Walker S., Kreichgauer H. P., Bode J. C. Terlipressin vs. somatostatin in bleeding esophageal varices: a controlled, double-blind study. Hepatology. 1992 Jun;15(6):1023–1030. doi: 10.1002/hep.1840150609. [DOI] [PubMed] [Google Scholar]
  168. Westaby D., Hayes P. C., Gimson A. E., Polson R. J., Williams R. Controlled clinical trial of injection sclerotherapy for active variceal bleeding. Hepatology. 1989 Feb;9(2):274–277. doi: 10.1002/hep.1840090219. [DOI] [PubMed] [Google Scholar]
  169. Westaby D., Macdougall B. R., Williams R. Improved survival following injection sclerotherapy for esophageal varices: final analysis of a controlled trial. Hepatology. 1985 Sep-Oct;5(5):827–830. doi: 10.1002/hep.1840050520. [DOI] [PubMed] [Google Scholar]
  170. Westaby D., Polson R. J., Gimson A. E., Hayes P. C., Hayllar K., Williams R. A controlled trial of oral propranolol compared with injection sclerotherapy for the long-term management of variceal bleeding. Hepatology. 1990 Mar;11(3):353–359. doi: 10.1002/hep.1840110304. [DOI] [PubMed] [Google Scholar]
  171. Williams S. G., Peters R. A., Westaby D. Thrombin--an effective treatment for gastric variceal haemorrhage. Gut. 1994 Sep;35(9):1287–1289. doi: 10.1136/gut.35.9.1287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  172. Witzel L., Wolbergs E., Merki H. Prophylactic endoscopic sclerotherapy of oesophageal varices. A prospective controlled study. Lancet. 1985 Apr 6;1(8432):773–775. doi: 10.1016/s0140-6736(85)91444-8. [DOI] [PubMed] [Google Scholar]
  173. de Franchis R. Developing consensus in portal hypertension. J Hepatol. 1996 Sep;25(3):390–394. doi: 10.1016/s0168-8278(96)80127-9. [DOI] [PubMed] [Google Scholar]

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