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Primary Prophylaxis of First Variceal Bleeding

  • Conference paper
Portal Hypertension VI

Abstract

In this chapter we support the idea that the treatment of primary liver disease can be an effective approach to prevent the development of clinical significant portal hypertension or decompensation in cirrhotic patients. Even the patients with esophageal varices may benefit from the cure of primary liver disease although there are not enough data about in whom, when, and to what extent reversibility can be achieved.

In the meanwhile nonselective beta-blockers (NSBB) remain a crucial cornerstone for the prophylaxis of variceal bleeding and decompensation. NSBB have shown no efficacy vs. placebo at early stages of disease and therefore are not indicated in these patients. Caution has been proposed for the use of NSBB in patients with refractory ascites or spontaneous bacterial peritonitis. When these patients are medicated with NSBB, they should be followed carefully for possible adverse events such as severe hypotension.

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Authors and Affiliations

  1. Gastroenterology, Department of Clinical Medicine, Sapienza University of Rome, Viale dell’Universita’ 37, Rome, 00185, Italy

    Manuela Merli

  2. Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA

    Roberto J. Groszmann

Authors
  1. Manuela Merli
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  2. Roberto J. Groszmann
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Correspondence to Manuela Merli .

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Editors and Affiliations

  1. Gastroenterology Unit, Luigi Sacco University Hospital, Milan, Italy

    Roberto de Franchis

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Merli, M., Groszmann, R.J. (2016). Primary Prophylaxis of First Variceal Bleeding. In: de Franchis, R. (eds) Portal Hypertension VI. Springer, Cham. https://doi.org/10.1007/978-3-319-23018-4_23

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  • DOI: https://doi.org/10.1007/978-3-319-23018-4_23

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23017-7

  • Online ISBN: 978-3-319-23018-4

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