Improved Survival with the Patients with Variceal Bleed
Variceal hemorrhage is a major cause of death in patients with cirrhosis. Over the past two decades new treatment modalities have been introduced in the management of acute variceal bleeding (AVB) and several recent studies have suggested that the outcome of patients with cirrhosis and AVB has impro...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | International Journal of Hepatology |
| Online Access: | http://dx.doi.org/10.4061/2011/356919 |
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| author | Praveen Sharma Shiv K. Sarin |
| author_facet | Praveen Sharma Shiv K. Sarin |
| author_sort | Praveen Sharma |
| collection | DOAJ |
| description | Variceal hemorrhage is a major cause of death in patients with cirrhosis. Over the past two decades new treatment modalities have been introduced in the management of acute variceal bleeding (AVB) and several recent studies have suggested that the outcome of patients with cirrhosis and AVB has improved. Improved supportive measures, combination therapy which include early use of portal pressure reducing drugs with low rates of adverse effects (somatostatin, octerotide or terlipressin) and endoscopic variceal ligation has become the first line treatment in the management of AVB. Short-term antibiotic prophylaxis, early use of lactulose for prevention of hepatic encephalopathy, application of early transjugular intrahepatic portasystemic shunts (TIPS), fully covered self-expandable metallic stent in patients for AVB may be useful in those cases where balloon tamponade is considered. Early and wide availability of liver transplantation has changed the armamentarium of the clinician for patients with AVB. High hepatic venous pressure gradient (HVPG) >20 mmHg in AVB has become a useful predictor of outcomes and more aggressive therapies with early TIPS based on HVPG measurement may be the treatment of choice to reduce mortality further. |
| format | Article |
| id | doaj-art-d8f432c14c794fca8680312b4e644760 |
| institution | Kabale University |
| issn | 2090-3448 2090-3456 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hepatology |
| spelling | doaj-art-d8f432c14c794fca8680312b4e6447602025-08-20T03:24:22ZengWileyInternational Journal of Hepatology2090-34482090-34562011-01-01201110.4061/2011/356919356919Improved Survival with the Patients with Variceal BleedPraveen Sharma0Shiv K. Sarin1Department of Hepatology and Transplant Hepatology, Institute of Liver & Biliary Sciences, New Delhi 110 070, IndiaDepartment of Hepatology and Transplant Hepatology, Institute of Liver & Biliary Sciences, New Delhi 110 070, IndiaVariceal hemorrhage is a major cause of death in patients with cirrhosis. Over the past two decades new treatment modalities have been introduced in the management of acute variceal bleeding (AVB) and several recent studies have suggested that the outcome of patients with cirrhosis and AVB has improved. Improved supportive measures, combination therapy which include early use of portal pressure reducing drugs with low rates of adverse effects (somatostatin, octerotide or terlipressin) and endoscopic variceal ligation has become the first line treatment in the management of AVB. Short-term antibiotic prophylaxis, early use of lactulose for prevention of hepatic encephalopathy, application of early transjugular intrahepatic portasystemic shunts (TIPS), fully covered self-expandable metallic stent in patients for AVB may be useful in those cases where balloon tamponade is considered. Early and wide availability of liver transplantation has changed the armamentarium of the clinician for patients with AVB. High hepatic venous pressure gradient (HVPG) >20 mmHg in AVB has become a useful predictor of outcomes and more aggressive therapies with early TIPS based on HVPG measurement may be the treatment of choice to reduce mortality further.http://dx.doi.org/10.4061/2011/356919 |
| spellingShingle | Praveen Sharma Shiv K. Sarin Improved Survival with the Patients with Variceal Bleed International Journal of Hepatology |
| title | Improved Survival with the Patients with Variceal Bleed |
| title_full | Improved Survival with the Patients with Variceal Bleed |
| title_fullStr | Improved Survival with the Patients with Variceal Bleed |
| title_full_unstemmed | Improved Survival with the Patients with Variceal Bleed |
| title_short | Improved Survival with the Patients with Variceal Bleed |
| title_sort | improved survival with the patients with variceal bleed |
| url | http://dx.doi.org/10.4061/2011/356919 |
| work_keys_str_mv | AT praveensharma improvedsurvivalwiththepatientswithvaricealbleed AT shivksarin improvedsurvivalwiththepatientswithvaricealbleed |