Evaluation and Management of Esophageal and Gastric Varices in Patients with Cirrhosis

Abstract

Variceal bleeding is a complication of cirrhosis that defines decompensation. Important advances in the management of gastroesophageal varices have led to a significant decrease in the morbidity and mortality. Achieving these results in clinical practice is contingent on clinicians applying the best practice strategies and appropriate referral to a tertiary center. Several quality metrics were developed by the American Association for the Study of Liver Diseases. This article aims to update outpatient and inpatient strategies to include the latest recommendations on variceal screening and surveillance, primary and secondary prophylaxis of variceal bleeding, and therapy for patients with acute variceal bleeding.

Keywords: Cirrhosis; Decompensated cirrhosis; Endoscopic variceal ligation; Esophageal varices; Gastric varices; Nonselective beta-blocker; Portal hypertension; Variceal bleeding.