[Therapy of bleeding esophageal varices. Attempt at a position statement]

Abstract

In recent years the technique of selective portasystemic shunting (Warren procedure) and sclerotherapy, and also the possibility of lowering portal pressure with beta-blockers, have changed the approach to management of patients with bleeding esophageal varices. Treatment of these patients is reviewed in the light of experience of 204 cases and the literature. The advantages and disadvantages of vasopressin, balloon tamponade, sclerotherapy, transhepatic embolization and various shunt and non-shunt operations in the acute phase are presented. For elective cases the discussion centers mainly on treatment by distal splenorenal shunt and sclerotherapy.