{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:01:09Z","timestamp":1791849669062,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2017,1,3]],"date-time":"2017-01-03T00:00:00Z","timestamp":1483401600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death. In patients with compensated liver disease, the correction of factors influencing the progression of fibrosis, in particular aetiologic factors, is now feasible in many cases and should be achieved to prevent the development or progression of gastroesophageal varices and hepatic decompensation. Once gastroesophageal varices have developed, non\u2010selective beta\u2010blockers remain the cornerstone of therapy. Carvedilol provides a greater decrease in portal pressure and is currently indicated as a first\u2010choice therapy for primary prophylaxis. The treatment of acute variceal haemorrhage includes a combination of vasoactive drugs, antibiotics and endoscopic variceal band ligation. In high\u2010risk patients, the early use of transjugular intrahepatic portosystemic shunt (<jats:styled-content style=\"fixed-case\">TIPS<\/jats:styled-content>) lowers the risk of re\u2010bleeding and improves survival. Transjugular intrahepatic portosystemic shunt is the choice for uncontrolled variceal bleeding; a self\u2010expandable metal stent or balloon tamponade can be used as a bridging measure. The combination of non\u2010selective beta\u2010blockers and endoscopic variceal band ligation reduces the risk of recurrent variceal bleeding and improves survival. In these cases, statins seem to further improve survival. Transjugular intrahepatic portosystemic shunt is indicated in patients who rebleed during secondary prophylaxis.<\/jats:p>","DOI":"10.1111\/liv.13277","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T04:15:37Z","timestamp":1484280937000},"page":"104-115","source":"Crossref","is-referenced-by-count":64,"title":["Prevention and treatment of variceal haemorrhage in 2017"],"prefix":"10.1111","volume":"37","author":[{"given":"Felix","family":"Brunner","sequence":"first","affiliation":[{"name":"Swiss Liver Center Hepatology University Clinic for Visceral Surgery and Medicine Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Berzigotti","sequence":"additional","affiliation":[{"name":"Swiss Liver Center Hepatology University Clinic for Visceral Surgery and Medicine Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Bosch","sequence":"additional","affiliation":[{"name":"Swiss Liver Center Hepatology University Clinic for Visceral Surgery and Medicine Inselspital, Bern University Hospital University of Bern  Bern Switzerland"},{"name":"Hepatic Hemodynamic Laboratory Hospital Clinic\u2010IDIBAPS and CIBEREHD University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2009.149"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.05.024"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.08.023"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00420-8"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044456"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810133191505"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0901512"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20339"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.04.006"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.001"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.10.013"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12721"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.01.003"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199907000-00011"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198112033052302"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199105303242202"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2009.02038.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840110212"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840360611"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50211"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12634"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-304038"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23045"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2013.12.003"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.22529"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840220117"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.33469"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.01.043"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.01.004"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.10.007"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.03.013"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-016-0616-x"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13177"},{"issue":"6","key":"e_1_2_10_36_1","first-page":"1379","article-title":"Emricasan (IDN\u20106556) administered orally for 28\u00a0days lowers portal pressure in patients with compensated cirrhosis and severe portal hypertension. AASLD 2015","volume":"62","author":"Garcia\u2010Tsao G","year":"2015","journal-title":"Hepatology"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i8.2534"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000119"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2007.01522.x"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02102.x"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3485-8"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.07.012"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1586\/17474124.2014.902303"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510290608"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007133"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27006"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0910102"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.08.020"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12626"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28360"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12452"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.09.013"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28318"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.05.011"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(97)70202-5"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fliv.13277","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.13277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T02:40:09Z","timestamp":1694659209000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.13277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":55,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1111\/liv.13277"],"URL":"https:\/\/doi.org\/10.1111\/liv.13277","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]}}}