Primary prevention and management of variceal bleeding: Review of Historical Evidence

Abstract

Background: Prevention and control of active bleeding caused by portal hypertension is still a challenge. Surgery used to be the only option in the earlier days, but now many options exist. Choice of the correct mode of treatment is important and is
determined by many factors dictated by the condition of each patient and the
available experience.
Methods: Publications written on the primary prevention and the management of acute
bleeding are selected by Internet search. The strength of evidence of each publication is determined using a defined classification method. The advice given is based on the available evidence.
Results: Seventy-two publications were retrieved. The level of evidence for each publication is given in the reference section.
Conclusion: Surgery should not be done for primary prophylaxis. For the control of acute bleeding surgery is preferred for Childs-Pough class A and B. For class C the procedure of choice is TIPS.

Keywords: sclerotherapy, band ligation, portal hypertension.

Sudan Journal of Medical Sciences Vol. 3 (1) 2008: pp. 49-62