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In this regard, the development of primary prophylaxis of variceal bleeding and its management according to the severity of portal hypertension may be promising. This paper is to describe the modern principles of primary prophylaxis of esophageal variceal bleeding in patients with liver cirrhosis. The PubMed and EMbase databases, Web of Science, Google Scholar, and the Cochrane Database of Systematic Reviews were used to search for relevant publications from 1999 to 2019. The results suggested that depending on the severity of portal hypertension, patients with cirrhosis should be divided into those who need preprimary prophylaxis, which aims to prevent the formation of esophageal varices, and those who require measures that aim to prevent esophageal variceal bleeding. In subclinical portal hypertension, therapy should be etiological and pathogenetic. Cirrhosis with clinically significant portal hypertension should receive nonselective \u03b2\u2010blockers if they have small esophageal varices and risk factors for variceal bleeding. Nonselective \u03b2\u2010blockers are the first\u2010line drugs for the primary prevention of bleeding from medium to large\u2010sized esophageal varices. Endoscopic band ligation is indicated for the patients who are intolerant to nonselective \u03b2\u2010blockers or in the case of contraindications to pharmacological therapy. In summary, the stratification of cirrhotic patients by the severity of portal hypertension and an individual approach to the choice of treatment may increase the effectiveness of therapy as well as improve survival rate of these patients.<\/jats:p>","DOI":"10.1111\/jebm.12407","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T02:32:18Z","timestamp":1602297138000},"page":"313-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Primary prevention of bleeding from esophageal varices in patients with liver cirrhosis: An update and review of the literature"],"prefix":"10.1111","volume":"13","author":[{"given":"Dmitry Victorovich","family":"Garbuzenko","sequence":"first","affiliation":[{"name":"Department of Faculty Surgery South Ural State Medical University Chelyabinsk Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay Olegovich","family":"Arefyev","sequence":"additional","affiliation":[{"name":"Department of Pathological Anatomy and Forensic Medicine South Ural State Medical University Chelyabinsk Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.039"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v8.i16.665"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v8.i36.1602"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2018.1506046"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8951"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i11.3212"},{"key":"e_1_2_10_8_1","first-page":"36","article-title":"Methods of risk prediction and monitoring of treatment response rate of bleedings from esophageal varices in patients with liver cirrhosis","volume":"22","author":"Garbuzenko DV","year":"2012","journal-title":"Ros Zhurn Gastrojenterol Gepatol Koloproktol"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01826.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640614527084"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i12.3441"},{"key":"e_1_2_10_12_1","first-page":"3","article-title":"A meta\u2010analysis of the value of vWF in the diagnosis of liver cirrhosis with portal hypertension","volume":"7","author":"Ding XC","year":"2019","journal-title":"J Clin Transl Hepatol"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03378.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2014.996590"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149230"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26700"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26755"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2015.16.2.314"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2007.01526.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.15.11106"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13121769"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2010.02326.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25752"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0121601"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-014-3476-3"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000269"},{"key":"e_1_2_10_27_1","first-page":"3329","article-title":"Noninvasive predictive model for hepatic venous pressure gradient based on a 3\u2010dimensional computed tomography volume rendering technology","volume":"15","author":"Tseng Y","year":"2018","journal-title":"Exp Ther Med"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.12.015"},{"key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jhep.2017.07.037","article-title":"Chinese Portal Hypertension Noninvasive Diagnosis Study (CHESS) Group. 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