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Updated: May 28, 2026
07:10
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Improved survival with the patients with variceal bleed
1Department of Hepatology and Transplant Hepatology, Institute of Liver & Biliary Sciences, New Delhi 110 070, India.
International Journal of Hepatology
|October 14, 2011
Summary
Acute variceal bleeding (AVB) in cirrhosis patients has improved outcomes due to new treatments. Early interventions like medications, endoscopic ligation, and transjugular intrahepatic portasystemic shunts (TIPS) reduce mortality.
Area of Science:
- Gastroenterology
- Hepatology
- Interventional Endoscopy
Background:
- Variceal hemorrhage is a significant cause of mortality in cirrhosis patients.
- Recent advancements have improved outcomes for acute variceal bleeding (AVB).
Purpose of the Study:
- To review new treatment modalities for acute variceal bleeding (AVB) in cirrhosis.
- To highlight improved outcomes and future directions in AVB management.
Main Methods:
- Review of recent studies on AVB management.
- Discussion of pharmacological therapies (somatostatin, octerotide, terlipressin).
- Evaluation of endoscopic variceal ligation, antibiotic prophylaxis, lactulose, TIPS, and stents.
Main Results:
- Combination therapy with portal pressure-reducing drugs and endoscopic variceal ligation is first-line for AVB.
- Early TIPS, especially in patients with high hepatic venous pressure gradient (HVPG) >20 mmHg, shows promise.
- Liver transplantation availability has expanded treatment options.
Conclusions:
- Improved supportive measures and early interventions enhance AVB patient outcomes.
- Aggressive therapies, including early TIPS guided by HVPG, may further reduce mortality.
- Multifaceted treatment strategies are crucial for managing AVB in cirrhosis.
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