{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:12:35Z","timestamp":1703722355498},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[1994,3,1]],"date-time":"1994-03-01T00:00:00Z","timestamp":762480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1994,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Portal hypertension is treated by reducing portal pressure in order to prevent esophageal variceal bleeding or recurrent bleeding. Because portal hypertension depends on both elevated portal tributary blood flow and intrahepatic vascular resistance, the pharmacologic therapy of this sydrome consists in reducing portal blood flow or vascular resistance, or both. The pharmacologic prevention of first bleeding or recurrent bleeding has been performed with nonselective \u03b2\u2010adrenergic antagonists (propranolol or nadolol). Certain controlled studies have shown that this type of drug signifcantly reduces the risk of first bleeding by approximately 40% in patients with esophageal varices. A meta\u2010analysis showed that death due to bleeding was also significantly lower in the \u03b2\u2010blocker group than in the placebo group. Moreover, \u03b2\u2010blockers are effective in patients in both good and poor condition and with all types of cirrhosis. The efficacy of \u03b2\u2010blockers on the risk of recurrent bleeding is less clear, but these substances significantly decrease the risk of rebleeding, by approximately 30%. Recurrent bleeding in patients treated with \u03b2\u2010blockers is associated with the occurrence of hepatocellular carcinoma or lack of compliance. In conclusion, it is clear that different substances have portal hypotensive effects and can be used to treat or prevent complications of portal hypertension. However, other drugs should be tested, and other clinical studies are needed to identify good responders.<\/jats:p>","DOI":"10.1007\/bf00294406","type":"journal-article","created":{"date-parts":[[2004,10,6]],"date-time":"2004-10-06T08:28:25Z","timestamp":1097051305000},"page":"229-232","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010term management of variceal bleeding: The place of pharmacotherapy"],"prefix":"10.1002","volume":"18","author":[{"given":"Didier","family":"Lebrec","sequence":"first","affiliation":[{"name":"Laboratoire d'H\u00e9modynamique Splanchnique Unit\u00e9 de Recherches de Physiopathologie H\u00e9patique (INSERM U\u201024) 92118 Clichy France"},{"name":"Service d'H\u00e9patologie H\u00f4pital Beaujon 92118 Clichy France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1994,3]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840120624"},{"key":"e_1_2_1_3_1","first-page":"851","article-title":"Propranolol in the prevention of variceal haemorrhage in alcoholic cirrhotic patients [abstract]","volume":"12","author":"Colman J.","year":"1990","journal-title":"Hepatology"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840130517"},{"key":"e_1_2_1_5_1","first-page":"118","article-title":"Nadolol can prevent the first gastrointestinal bleeding in cirrhotics: a prospective, randomized study","volume":"7","author":"Id\u00e9o G.","year":"1988","journal-title":"Hepatology"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(88)80515-4"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198710013171403"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840140612"},{"key":"e_1_2_1_9_1","first-page":"1395","article-title":"A randomized controlled trial for the prevention of the first upper gastrointestinal bleeding due to portal hypertension in cirrhosis: sclerotherapy or propranolol versus control groups [abstract]","volume":"8","author":"Strauss E.","year":"1988","journal-title":"Hepatology"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(89)90078-0"},{"key":"e_1_2_1_11_1","first-page":"823","article-title":"Propranolol in chronic liver disease: a controlled trial of its effect and safety over twelve months","volume":"65","author":"Hayes P.C.","year":"1987","journal-title":"Q. 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