. 2017 Feb 27;2017:bcr2016218669. doi: 10.1136/bcr-2016-218669

Table 1.

Summary of risks and benefits of the current therapeutic options in management of duodenal varices

Therapeutic options		Benefits	Risks
Endoscopic	Variceal banding	Relatively non-invasive²³ Reported success² ¹⁴ ¹⁷ ²² ²⁴	Risk of recurrence Rebleeding rate high²⁴ Can cause wider defect¹ ² ⁶ ²² Visualisation difficult¹ ² ⁶ ²²
Endoscopic	Variceal sclerotherapy	Relatively non-invasive²³ Reported success³ ¹³ ²⁰ ²¹ ²⁴	Tissue damage³ ⁶ ¹⁷ ²⁴ Ulceration³ ⁶ ¹⁷ ²⁴ Perforation³ ⁶ ¹⁷ ²⁴ Risk of pulmonary embolism of sclerosant³ ⁶ ¹⁷ ²⁴ Visualisation difficult³ ⁶ ¹⁷ ²⁴
Interventional radiology	Transjugular intrahepatic portosystemic shunt (TIPSS)	Very effective Option in poor surgical candidate⁶ ²⁵ Option in refractory cases⁶ ²⁵ Decrease portosystemic pressure gradient⁶ ²⁵	Hepatic encephalopathy⁶ ²⁵ Stenosis of stent common (55–70%)⁶ ²⁵
Interventional radiology	Balloon occluded retrograde transvenous obliteration (BRTO)	Management for life-threatening bleeding¹⁴ ²⁴	Recanalisation or development of collaterals¹⁴ ²⁴
Surgical	Variceal ligation	For cases refractory to endoscopic intervention⁷ ¹⁴	Rebleeding rate high⁷ ¹⁴ Risk of further management⁷ ¹⁴ Invasive⁷ ¹⁴
	Duodenectomy	For cases refractory to endoscopic intervention⁷ ¹⁴	Rebleeding rate high⁷ ¹⁴ Risk of further management Invasive⁷ ¹⁴
	Shunt surgery	Little risk of rebleeding⁷ ¹⁴ Decrease portosystemic pressure gradient⁷ ¹⁴	30% mortality rate⁶ Require good hepatic function⁷ ¹⁴ Invasive⁷ ¹⁴