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Treatment of portalhypertension Khurram BariGuadalupe García‐Tsao2012 год

Treatment of portal hypertension
review

Полный текстСтраница публикацииПубликация в OpenAlex
Аннотация: Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg.Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more.Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension.Over the last decades significant advancements in the field have led to standard treatment options.These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed.Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension.No specific treatment has shown to prevent the formation of varices.Prevention of first variceal hemorrhage depends on the size/characteristics of varices.In patients with small varices and high risk of bleeding, nonselective b-blockers are recommended, while patients with medium/large varices can be treated with either b-blockers or esophageal band ligation.Standard of care for acute variceal hemorrhage consists of vasoactive drugs, endoscopic band ligation and antibiotics prophylaxis.Transjugular intrahepatic portosystemic shunt (TIPS) is reserved for those who fail standard of care or for patients who are likely to fail ("early TIPS").Prevention of recurrent variceal hemorrhage consists of the combination of b-blockers and endoscopic band ligation.
Год издания: 2012
Авторы: Khurram Bari, Guadalupe García‐Tsao
Издательство: Baishideng Publishing Group
Источник: World Journal of Gastroenterology
Ключевые слова: Liver Disease and Transplantation, Liver Disease Diagnosis and Treatment, Organ Transplantation Techniques and Outcomes
Другие ссылки: World Journal of Gastroenterology (HTML)
Europe PMC (PubMed Central) (PDF)
Europe PMC (PubMed Central) (HTML)
PubMed Central (HTML)
PubMed (HTML)