{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T10:13:58Z","timestamp":1794564838632,"version":"4.9.1"},"reference-count":228,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Gut"],"accepted":{"date-parts":[[2015,3,17]]},"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:p>These updated guidelines on the management of variceal haemorrhage have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines which this document supersedes were written in 2000 and have undergone extensive revision by 13 members of the Guidelines Development Group (GDG). The GDG comprises elected members of the BSG liver section, representation from British Association for the Study of the Liver (BASL) and Liver QuEST, a nursing representative and a patient representative. The quality of evidence and grading of recommendations was appraised using the AGREE II tool.<\/jats:p>\n                  <jats:p>The nature of variceal haemorrhage in cirrhotic patients with its complex range of complications makes rigid guidelines inappropriate. These guidelines deal specifically with the management of varices in patients with cirrhosis under the following subheadings: (1) primary prophylaxis; (2) acute variceal haemorrhage; (3) secondary prophylaxis of variceal haemorrhage; and (4) gastric varices. They are not designed to deal with (1) the management of the underlying liver disease; (2) the management of variceal haemorrhage in children; or (3) variceal haemorrhage from other aetiological conditions.<\/jats:p>","DOI":"10.1136\/gutjnl-2015-309262","type":"journal-article","created":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T21:02:39Z","timestamp":1429304559000},"page":"1680-1704","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":528,"title":["UK guidelines on the management of variceal haemorrhage in cirrhotic patients"],"prefix":"10.1136","volume":"64","author":[{"given":"Dhiraj","family":"Tripathi","sequence":"first","affiliation":[{"name":"Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian J","family":"Stanley","sequence":"additional","affiliation":[{"name":"GI Unit, Glasgow Royal Infirmary, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C","family":"Hayes","sequence":"additional","affiliation":[{"name":"Liver Unit, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Patch","sequence":"additional","affiliation":[{"name":"The Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Millson","sequence":"additional","affiliation":[{"name":"Gastrointestinal and Liver Services, York Teaching Hospitals NHS Foundation Trust, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Homoyon","family":"Mehrzad","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Derby Hospitals NHS Foundation Trust, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon P","family":"Olliff","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hudson","sequence":"additional","affiliation":[{"name":"Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Christie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Royal Devon and Exeter Hospital, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,4,17]]},"reference":[{"key":"2025121220530658000_64.11.1680.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.06.004"},{"key":"2025121220530658000_64.11.1680.2","unstructured":"Acute upper gastrointestinal bleeding: management. NICE , 2012. http:\/\/www.nice.org.uk\/Guidance\/CG141"},{"key":"2025121220530658000_64.11.1680.3","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090449"},{"key":"2025121220530658000_64.11.1680.4","unstructured":"Centre for evidence-based medicine. Oxford: Oxford University, 2009."},{"key":"2025121220530658000_64.11.1680.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.12.010"},{"key":"2025121220530658000_64.11.1680.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0910102"},{"key":"2025121220530658000_64.11.1680.7","unstructured":"Measuring the Units. A review of patients who died with alcohol-related liver disease. NCEPOD , 2013. http:\/\/www.ncepod.org.uk\/2013report1\/downloads\/Measuring%20the%20Units_full%20report.pdf"},{"key":"2025121220530658000_64.11.1680.8","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32833aa15f"},{"key":"2025121220530658000_64.11.1680.9","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318227422d"},{"key":"2025121220530658000_64.11.1680.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-012-0493-y"},{"key":"2025121220530658000_64.11.1680.11","unstructured":"Scope for improvement: a toolkit for a safer upper gastrointestinal bleeding (UGIB) service. 2011. http:\/\/www aomrc org uk\/doc_download\/9338-upper-gastrointestinal-bleeding-toolkit"},{"key":"2025121220530658000_64.11.1680.12","doi-asserted-by":"crossref","unstructured":"McPherson S , Dyson J , Austin A , et al . Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis\u2014the first 24 h. Frontline Gastroenterology Published Online First: 2 Dec 2014 doi:10.1136\/flgastro-2014-100491","DOI":"10.1136\/flgastro-2014-100491"},{"key":"2025121220530658000_64.11.1680.13","unstructured":"Darzi A . High quality care for all: NHS Next Stage Review final report. London: DoH, 2008."},{"key":"2025121220530658000_64.11.1680.14","unstructured":"Liver Quality Enhancement Service Tool (QuEST). 2015. http:\/\/www liverquest org uk\/"},{"key":"2025121220530658000_64.11.1680.15","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1016\/S0140-6736(14)62263-7","article-title":"Tackling liver disease in the UK: a Lancet Commission","volume":"384","year":"2014","journal-title":"Lancet"},{"key":"2025121220530658000_64.11.1680.16","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27407"},{"key":"2025121220530658000_64.11.1680.17","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27441"},{"key":"2025121220530658000_64.11.1680.18","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/S0016-5085(81)80123-0","article-title":"Aspects of the natural history of gastrointestinal bleeding in cirrhosis and the effect of prednisone","volume":"81","author":"Christensen","year":"1981","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.19","first-page":"245","article-title":"[Natural history of esophageal varices in cirrhosis (from origin to rupture)]","volume":"12","author":"Cales","year":"1988","journal-title":"Gastroenterol Clin Biol"},{"issue":"(4 Pt 1)","key":"2025121220530658000_64.11.1680.20","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/0016-5085(79)90212-9","article-title":"Development and early prognosis of esophageal varices in severe chronic active liver disease (CALD) treated with prednisone","volume":"77","author":"Czaja","year":"1979","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00420-8"},{"key":"2025121220530658000_64.11.1680.22","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12721"},{"key":"2025121220530658000_64.11.1680.23","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(59)90311-0"},{"key":"2025121220530658000_64.11.1680.24","first-page":"520","article-title":"The natural history of esophageal varices in patients with alcoholic liver cirrhosis. An endoscopic and clinical study","volume":"57","author":"Dagradi","year":"1972","journal-title":"Am J Gastroenterol"},{"key":"2025121220530658000_64.11.1680.25","first-page":"450","article-title":"Clinical and portal hemodynamic features in cirrhotic patients having a large spontaneous splenorenal and\/or gastrorenal shunt","volume":"81","author":"Ohnishi","year":"1986","journal-title":"Am J Gastroenterol"},{"key":"2025121220530658000_64.11.1680.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(85)80745-5"},{"key":"2025121220530658000_64.11.1680.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044456"},{"key":"2025121220530658000_64.11.1680.28","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1291483"},{"key":"2025121220530658000_64.11.1680.29","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1256474"},{"key":"2025121220530658000_64.11.1680.30","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22227"},{"key":"2025121220530658000_64.11.1680.31","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.66"},{"key":"2025121220530658000_64.11.1680.32","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21665"},{"key":"2025121220530658000_64.11.1680.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.08.018"},{"key":"2025121220530658000_64.11.1680.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.01.051"},{"key":"2025121220530658000_64.11.1680.35","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00874.x"},{"key":"2025121220530658000_64.11.1680.36","first-page":"431","article-title":"Platelet count\/spleen diameter ratio to predict the presence of esophageal varices in patients with cirrhosis: a systematic review","volume":"24","author":"Chawla","year":"2012","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025121220530658000_64.11.1680.37","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)90378-6"},{"key":"2025121220530658000_64.11.1680.38","doi-asserted-by":"publisher","DOI":"10.1136\/gut.26.8.843"},{"key":"2025121220530658000_64.11.1680.39","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840050313"},{"key":"2025121220530658000_64.11.1680.40","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/0016-5085(80)90905-1","article-title":"Portal hypertension, size of esophageal varices, and risk of gastrointestinal bleeding in alcoholic cirrhosis","volume":"79","author":"Lebrec","year":"1980","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.41","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/0016-5085(90)91168-6","article-title":"Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage","volume":"99","author":"Groszmann","year":"1990","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.42","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91740-3"},{"key":"2025121220530658000_64.11.1680.43","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.2.270"},{"key":"2025121220530658000_64.11.1680.44","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840060122"},{"key":"2025121220530658000_64.11.1680.45","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0016-5085(56)80066-8","article-title":"Correlation between the severity of esophageal varices in portal cirrhosis and their propensity toward hemorrhage","volume":"30","author":"Palmer","year":"1956","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.46","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040614"},{"key":"2025121220530658000_64.11.1680.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.11.033"},{"key":"2025121220530658000_64.11.1680.48","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(81)73224-3"},{"key":"2025121220530658000_64.11.1680.49","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810133191505"},{"key":"2025121220530658000_64.11.1680.50","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840120102"},{"key":"2025121220530658000_64.11.1680.51","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/0016-5085(91)90738-7","article-title":"Prophylactic sclerotherapy in high-risk cirrhotics selected by endoscopic criteria. A multicenter randomized controlled trial","volume":"101","author":"de Franchis","year":"1991","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.52","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v111.pm8898643"},{"key":"2025121220530658000_64.11.1680.53","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/0016-5085(92)90185-2","article-title":"Prognostic usefulness of hepatic vein catheterization in patients with cirrhosis and esophageal varices","volume":"102","author":"Merkel","year":"1992","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.54","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.03.048"},{"key":"2025121220530658000_64.11.1680.55","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21089"},{"key":"2025121220530658000_64.11.1680.56","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(89)90078-0"},{"key":"2025121220530658000_64.11.1680.57","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(91)90261-S"},{"key":"2025121220530658000_64.11.1680.58","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840080103"},{"key":"2025121220530658000_64.11.1680.59","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(88)80515-4"},{"key":"2025121220530658000_64.11.1680.60","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198710013171403"},{"key":"2025121220530658000_64.11.1680.61","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199907000-00011"},{"key":"2025121220530658000_64.11.1680.62","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.05.004"},{"key":"2025121220530658000_64.11.1680.63","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-012-9353-8"},{"key":"2025121220530658000_64.11.1680.64","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196506172722402"},{"key":"2025121220530658000_64.11.1680.65","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-197201000-00002"},{"key":"2025121220530658000_64.11.1680.66","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(68)90127-X"},{"key":"2025121220530658000_64.11.1680.67","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-70-4-675"},{"key":"2025121220530658000_64.11.1680.68","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(95)90388-7"},{"key":"2025121220530658000_64.11.1680.69","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840060119"},{"key":"2025121220530658000_64.11.1680.70","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.04.015"},{"key":"2025121220530658000_64.11.1680.71","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.3748\/wjg.v9.i8.1836","article-title":"Meta analysis of propranolol effects on gastrointestinal hemorrhage in cirrhotic patients","volume":"9","author":"Cheng","year":"2003","journal-title":"World J Gastroenterol"},{"key":"2025121220530658000_64.11.1680.72","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.36947"},{"key":"2025121220530658000_64.11.1680.73","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2012.666673"},{"key":"2025121220530658000_64.11.1680.74","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-304038"},{"key":"2025121220530658000_64.11.1680.75","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23045"},{"key":"2025121220530658000_64.11.1680.76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.11.019"},{"key":"2025121220530658000_64.11.1680.77","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23775"},{"key":"2025121220530658000_64.11.1680.78","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301348"},{"key":"2025121220530658000_64.11.1680.79","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306502"},{"key":"2025121220530658000_64.11.1680.80","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.03.005"},{"key":"2025121220530658000_64.11.1680.81","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/0016-5085(89)91630-2","article-title":"Reduction of portal pressure by isosorbide-5-mononitrate in patients with cirrhosis. Effects on splanchnic and systemic hemodynamics and liver function","volume":"96","author":"Navasa","year":"1989","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.82","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1016\/0016-5085(93)90356-H","article-title":"Isosorbide-5-mononitrate versus propranolol in the prevention of first bleeding in cirrhosis","volume":"104","author":"Angelico","year":"1993","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.83","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0168-8278(00)80445-6","article-title":"Isosorbide-5-monitrate (ISMN) vs placebo (PLA) in the prevention of the first variceal bleeding (FVB) in patients with contraindications or intolerance to beta-blockers","volume":"32","author":"Garcia-Pagan","year":"2000","journal-title":"J Hepatol"},{"key":"2025121220530658000_64.11.1680.84","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)05406-2"},{"key":"2025121220530658000_64.11.1680.85","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50211"},{"key":"2025121220530658000_64.11.1680.86","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-011-0472-0"},{"key":"2025121220530658000_64.11.1680.87","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12875"},{"key":"2025121220530658000_64.11.1680.88","unstructured":"Terg R , Casciato P , Garbe C , et al . Proton pump inhibitor therapy does not increase the incidence of spontaneous bacterial peritonitis in cirrhosis: a multicenter prospective study. J Hepatol 2014. Doi:10.1016\/j.jhep. 2014.11.036 doi:10.1016\/j.jhep.2014.11.036"},{"key":"2025121220530658000_64.11.1680.89","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13061"},{"key":"2025121220530658000_64.11.1680.90","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.179"},{"key":"2025121220530658000_64.11.1680.91","first-page":"CD004544","article-title":"Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults","volume":"8","author":"Gluud","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121220530658000_64.11.1680.92","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S1665-2681(19)30934-2","article-title":"Meta-analysis: beta-blockers versus banding ligation for primary prophylaxis of esophageal variceal bleeding","volume":"11","author":"Funakoshi","year":"2012","journal-title":"Ann Hepatol"},{"key":"2025121220530658000_64.11.1680.93","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2014.06.013"},{"key":"2025121220530658000_64.11.1680.94","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2000.105983"},{"key":"2025121220530658000_64.11.1680.95","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.1999.01841.x"},{"key":"2025121220530658000_64.11.1680.96","first-page":"1","article-title":"Ligation plus low-volume sclerotherapy for high-risk esophageal varices: comparisons with ligation therapy or sclerotherapy alone","volume":"33","author":"Masumoto","year":"1998","journal-title":"J Gastroenterol"},{"key":"2025121220530658000_64.11.1680.97","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/0016-5085(81)90144-X","article-title":"The course of patients after variceal hemorrhage","volume":"80","author":"Graham","year":"1981","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.98","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.22172"},{"key":"2025121220530658000_64.11.1680.99","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1053\/jhep.2003.50385","article-title":"Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators","volume":"38","author":"D'Amico","year":"2003","journal-title":"Hepatology"},{"key":"2025121220530658000_64.11.1680.100","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.10.008"},{"key":"2025121220530658000_64.11.1680.101","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.137489"},{"key":"2025121220530658000_64.11.1680.102","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajg.2013.05.001"},{"key":"2025121220530658000_64.11.1680.103","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.10.018"},{"key":"2025121220530658000_64.11.1680.104","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12744"},{"key":"2025121220530658000_64.11.1680.105","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.07.038"},{"key":"2025121220530658000_64.11.1680.106","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"2025121220530658000_64.11.1680.107","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198806000-00001"},{"key":"2025121220530658000_64.11.1680.108","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"2025121220530658000_64.11.1680.109","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.03.035"},{"key":"2025121220530658000_64.11.1680.110","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05088.x"},{"key":"2025121220530658000_64.11.1680.111","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27006"},{"key":"2025121220530658000_64.11.1680.112","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840020602"},{"key":"2025121220530658000_64.11.1680.113","first-page":"CD002147","article-title":"Terlipressin for acute esophageal variceal hemorrhage","volume":"1","author":"Ioannou","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121220530658000_64.11.1680.114","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.11.019"},{"key":"2025121220530658000_64.11.1680.115","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/0016-5085(81)90014-7","article-title":"Effects of somatostatin on hepatic and systemic hemodynamics in patients with cirrhosis of the liver: comparison with vasopressin","volume":"80","author":"Bosch","year":"1981","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.116","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04746.x"},{"key":"2025121220530658000_64.11.1680.117","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.07.010"},{"key":"2025121220530658000_64.11.1680.118","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12107"},{"key":"2025121220530658000_64.11.1680.119","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.78"},{"key":"2025121220530658000_64.11.1680.120","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(88)71274-2"},{"key":"2025121220530658000_64.11.1680.121","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-123-4-199508150-00007"},{"key":"2025121220530658000_64.11.1680.122","first-page":"438","article-title":"A randomized-controlled trial of endoscopic treatment of acute esophageal variceal hemorrhage: N-butyl-2-cyanoacrylate injection vs. variceal ligation","volume":"58","author":"Ljubicic","year":"2011","journal-title":"Hepatogastroenterology"},{"key":"2025121220530658000_64.11.1680.123","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.07.037"},{"key":"2025121220530658000_64.11.1680.124","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.31354"},{"key":"2025121220530658000_64.11.1680.125","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250509"},{"key":"2025121220530658000_64.11.1680.126","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.05.016"},{"key":"2025121220530658000_64.11.1680.127","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536031"},{"key":"2025121220530658000_64.11.1680.128","first-page":"566","article-title":"Esophageal tamponade for bleeding varices. Controlled trial between the Sengstaken-Blakemore tube and the Linton-Nachlas tube","volume":"75","author":"Teres","year":"1978","journal-title":"Gastroenterology"},{"key":"2025121220530658000_64.11.1680.129","doi-asserted-by":"publisher","DOI":"10.1159\/000335081"},{"key":"2025121220530658000_64.11.1680.130","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.07.028"},{"key":"2025121220530658000_64.11.1680.131","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00321-5"},{"key":"2025121220530658000_64.11.1680.132","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.12.042"},{"key":"2025121220530658000_64.11.1680.133","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-012-2003-6"},{"key":"2025121220530658000_64.11.1680.134","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2007.01522.x"},{"key":"2025121220530658000_64.11.1680.135","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.01.015"},{"key":"2025121220530658000_64.11.1680.136","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20386"},{"key":"2025121220530658000_64.11.1680.137","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.08.020"},{"key":"2025121220530658000_64.11.1680.138","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12934"},{"key":"2025121220530658000_64.11.1680.139","doi-asserted-by":"publisher","DOI":"10.1159\/000065097"},{"key":"2025121220530658000_64.11.1680.140","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007133"},{"key":"2025121220530658000_64.11.1680.141","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2000.8106"},{"key":"2025121220530658000_64.11.1680.142","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04418.x"},{"key":"2025121220530658000_64.11.1680.143","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2012.07244.x"},{"key":"2025121220530658000_64.11.1680.144","doi-asserted-by":"crossref","first-page":"S525","DOI":"10.1016\/S0168-8278(14)61462-8","article-title":"Addition of simvastatin to standard treatment improves survival after variceal bleeding in patients with cirrhosis. A double-blind randomized trial","volume":"60","author":"Abraldes","year":"2014","journal-title":"J Hepatol"},{"key":"2025121220530658000_64.11.1680.145","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20593"},{"key":"2025121220530658000_64.11.1680.146","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007131"},{"key":"2025121220530658000_64.11.1680.147","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840220242"},{"key":"2025121220530658000_64.11.1680.148","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12538"},{"key":"2025121220530658000_64.11.1680.149","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-1618-9"},{"key":"2025121220530658000_64.11.1680.150","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05540.x"},{"key":"2025121220530658000_64.11.1680.151","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.35351"},{"key":"2025121220530658000_64.11.1680.152","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22358"},{"key":"2025121220530658000_64.11.1680.153","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.35955"},{"key":"2025121220530658000_64.11.1680.154","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03007.x"},{"key":"2025121220530658000_64.11.1680.155","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.06.015"},{"key":"2025121220530658000_64.11.1680.156","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1155\/2011\/346705","article-title":"Endoscopic band ligation versus pharmacological therapy for variceal bleeding in cirrhosis: a meta-analysis","volume":"25","author":"Li","year":"2011","journal-title":"Can J Gastroenterol"},{"key":"2025121220530658000_64.11.1680.157","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04075.x"},{"key":"2025121220530658000_64.11.1680.158","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.2151"},{"key":"2025121220530658000_64.11.1680.159","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.02.029"},{"key":"2025121220530658000_64.11.1680.160","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-2-200807150-00007"},{"key":"2025121220530658000_64.11.1680.161","first-page":"5982","article-title":"Benefit of combination beta-blocker and endoscopic treatment to prevent variceal rebleeding: a meta-analysis","volume":"16","author":"Funakoshi","year":"2010","journal-title":"World J Gastroenterol"},{"key":"2025121220530658000_64.11.1680.162","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05074.x"},{"key":"2025121220530658000_64.11.1680.163","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12452"},{"key":"2025121220530658000_64.11.1680.164","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.212.2.r99au46411"},{"key":"2025121220530658000_64.11.1680.165","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80191-3"},{"key":"2025121220530658000_64.11.1680.166","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31815576e6"},{"key":"2025121220530658000_64.11.1680.167","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510290125"},{"key":"2025121220530658000_64.11.1680.168","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12391"},{"key":"2025121220530658000_64.11.1680.169","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.09.035"},{"key":"2025121220530658000_64.11.1680.170","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.02.008"},{"key":"2025121220530658000_64.11.1680.171","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.jhep.2007.08.014","article-title":"Cost of preventing variceal rebleeding with transjugular intrahepatic portal systemic shunt and distal splenorenal shunt","volume":"48","author":"Boyer","year":"2008","journal-title":"J Hepatol"},{"key":"2025121220530658000_64.11.1680.172","first-page":"CD000553","article-title":"Portosystemic shunts versus endoscopic therapy for variceal rebleeding in patients with cirrhosis","volume":"4","author":"Khan","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121220530658000_64.11.1680.173","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-013-2810-1"},{"key":"2025121220530658000_64.11.1680.174","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.131730"},{"key":"2025121220530658000_64.11.1680.175","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840160607"},{"key":"2025121220530658000_64.11.1680.176","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(86)71843-9"},{"key":"2025121220530658000_64.11.1680.177","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(91)90068-M"},{"key":"2025121220530658000_64.11.1680.178","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1997.tb00430.x"},{"key":"2025121220530658000_64.11.1680.179","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/S0140-6736(05)64972-0","article-title":"Endoscopic ligation of gastric varices","volume":"348","author":"Takeuchi","year":"1996","journal-title":"Lancet"},{"key":"2025121220530658000_64.11.1680.180","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.06.030"},{"key":"2025121220530658000_64.11.1680.181","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.05.019"},{"key":"2025121220530658000_64.11.1680.182","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/j.jhep.2011.12.021","article-title":"Efficacy of non-selective beta-blockers as adjunct to endoscopic prophylactic treatment for gastric variceal bleeding: a randomized controlled trial","volume":"56","author":"Hung","year":"2012","journal-title":"J Hepatol"},{"key":"2025121220530658000_64.11.1680.183","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3148-9"},{"key":"2025121220530658000_64.11.1680.184","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1996.tb00010.x"},{"key":"2025121220530658000_64.11.1680.185","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2000.107911"},{"key":"2025121220530658000_64.11.1680.186","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.24116"},{"key":"2025121220530658000_64.11.1680.187","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.192039"},{"key":"2025121220530658000_64.11.1680.188","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1005712"},{"key":"2025121220530658000_64.11.1680.189","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcq161"},{"key":"2025121220530658000_64.11.1680.190","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840100415"},{"key":"2025121220530658000_64.11.1680.191","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.05.009"},{"key":"2025121220530658000_64.11.1680.192","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1018288"},{"key":"2025121220530658000_64.11.1680.193","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21145"},{"key":"2025121220530658000_64.11.1680.194","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S1665-2681(19)30907-X","article-title":"Band ligation vs. N-butyl-2-cyanoacrylate injection in acute gastric variceal bleeding: a prospective follow-up study","volume":"13","author":"Tantau","year":"2013","journal-title":"Ann Hepatol"},{"key":"2025121220530658000_64.11.1680.195","doi-asserted-by":"publisher","DOI":"10.1136\/gut.35.9.1287"},{"key":"2025121220530658000_64.11.1680.196","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026626212129"},{"key":"2025121220530658000_64.11.1680.197","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.02.065"},{"key":"2025121220530658000_64.11.1680.198","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i41.5912"},{"key":"2025121220530658000_64.11.1680.199","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000119"},{"key":"2025121220530658000_64.11.1680.200","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.07.024"},{"key":"2025121220530658000_64.11.1680.201","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1326258"},{"key":"2025121220530658000_64.11.1680.202","first-page":"431","article-title":"[Treatment of hemorrhages by rupture of cardio-tuberous varices with transjugular intrahepatic portasystemic shunt]","volume":"17","author":"Kuradusenge","year":"1993","journal-title":"Gastroenterol Clin Biol"},{"key":"2025121220530658000_64.11.1680.203","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v111.pm8698192"},{"key":"2025121220530658000_64.11.1680.204","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1997.106277000.x"},{"key":"2025121220530658000_64.11.1680.205","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300523"},{"key":"2025121220530658000_64.11.1680.206","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(98)00640-4"},{"key":"2025121220530658000_64.11.1680.207","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-966591"},{"key":"2025121220530658000_64.11.1680.208","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.03.1169"},{"key":"2025121220530658000_64.11.1680.209","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.08769.x"},{"key":"2025121220530658000_64.11.1680.210","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.167.5.8911204"},{"key":"2025121220530658000_64.11.1680.211","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2003.4.2.109"},{"key":"2025121220530658000_64.11.1680.212","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2008.05651.x"},{"key":"2025121220530658000_64.11.1680.213","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2012.18.4.368"},{"key":"2025121220530658000_64.11.1680.214","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12508"},{"key":"2025121220530658000_64.11.1680.215","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2266"},{"key":"2025121220530658000_64.11.1680.216","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-009-9679-3"},{"key":"2025121220530658000_64.11.1680.217","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2013.12.001"},{"key":"2025121220530658000_64.11.1680.218","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1284454"},{"key":"2025121220530658000_64.11.1680.219","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i5.706"},{"key":"2025121220530658000_64.11.1680.220","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.12.1389"},{"key":"2025121220530658000_64.11.1680.221","first-page":"87","article-title":"Laparoscopic splenectomy for the treatment of gastric varices secondary to sinistral portal hypertension","volume":"14","author":"Jaroszewski","year":"2000","journal-title":"Surg Endosc"},{"key":"2025121220530658000_64.11.1680.222","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.avsg.2013.07.014","article-title":"Splenic artery embolization for the treatment of bleeding gastric varices secondary to splenic vein thrombosis","volume":"28","author":"Stone","year":"2014","journal-title":"Ann Vasc Surg"},{"key":"2025121220530658000_64.11.1680.223","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800770318"},{"key":"2025121220530658000_64.11.1680.224","first-page":"291","article-title":"[Results of devascularization surgery of the gastroesophageal junction in recurrent hemorrhage of esophageal and fundus varices]","volume":"119","author":"Riemenschneider","year":"1994","journal-title":"Zentralbl Chir"},{"key":"2025121220530658000_64.11.1680.225","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810227"},{"key":"2025121220530658000_64.11.1680.226","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.09.031"},{"key":"2025121220530658000_64.11.1680.227","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i11.1494"},{"key":"2025121220530658000_64.11.1680.228","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2342-10-2"}],"updated-by":[{"DOI":"10.1136\/gutjnl-2015-309262corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000}}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gutjnl-2015-309262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T04:53:19Z","timestamp":1765601599000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gutjnl-2015-309262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,17]]},"references-count":228,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2015,10,8]]},"published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1136\/gutjnl-2015-309262"],"URL":"https:\/\/doi.org\/10.1136\/gutjnl-2015-309262","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,17]]}}}