Update on management of gastric varices

Area of Science:

• Gastroenterology
• Hepatology
• Clinical Management

Background:

• Gastric varices (GV) present distinct physiological and clinical features compared to oesophageal varices (OV).
• Current management guidelines for GV are largely extrapolated from studies predominantly featuring OV, resulting in limited robust evidence.
• There is a significant knowledge gap regarding the optimal therapeutic approaches for GV.

Purpose of the Study:

• To conduct a comprehensive review of all management aspects for gastric varices.
• To critically evaluate the evidence base underpinning current international society recommendations for GV.
• To identify and highlight areas requiring further research in GV management.

Main Methods:

• Systematic literature review of studies pertaining to gastric varices.
• Critical appraisal of existing international society guidelines and their supporting evidence.
• Analysis of primary, secondary prophylaxis, and acute bleeding management strategies for GV.

Main Results:

• The review highlights the scarcity of high-quality evidence specifically for gastric varices management.
• Existing recommendations often lack direct support from studies focused on GV.
• Key areas for future research in GV prophylaxis and acute bleeding management have been identified.

Conclusions:

• Current management strategies for gastric varices require further investigation due to limited specific evidence.
• Evidence-based guidelines tailored to gastric varices are needed.
• Further research is crucial to improve the clinical outcomes for patients with gastric varices.