{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:01:50Z","timestamp":1791849710520,"version":"4.3.4"},"reference-count":74,"publisher":"The Korean Association for the Study of the Liver","issue":"4","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-cmh.org"],"crossmark-restriction":true},"short-container-title":["Clin Mol Hepatol"],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:p>Managing liver cirrhosis in clinical practice is still a challenging problem as its progression is associated with serious complications, such as variceal bleeding that may increase mortality. Portal hypertension (PH) is the main key for the development of liver cirrhosis complications. Portal pressure above 10 mmHg, termed as clinically significant portal hypertension, is associated with formation of varices; meanwhile, portal pressure above 12 mmHg is associated with variceal bleeding. Hepatic vein pressure gradient measurement and esophagogastroduodenoscopy remain the gold standard for assessing portal pressure and detecting varices. Recently, non-invasive methods have been studied for evaluation of portal pressure and varices detection in liver cirrhotic patients. Various guidelines have been published for clinicians\u2019 guidance in the management of esophagogastric varices which aims to prevent development of varices, acute variceal bleeding, and variceal rebleeding. This writing provides a comprehensive review on development of PH and varices in liver cirrhosis patients and its management based on current international guidelines and real experience in Indonesia.<\/jats:p>","DOI":"10.3350\/cmh.2020.0022","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T07:08:29Z","timestamp":1602054509000},"page":"444-460","update-policy":"https:\/\/doi.org\/10.3350\/crossmark_policy","source":"Crossref","is-referenced-by-count":104,"title":["Managing liver cirrhotic complications: Overview of esophageal and gastric varices"],"prefix":"10.3350","volume":"26","author":[{"given":"Cosmas Rinaldi Adithya","family":"Lesmana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Raharjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rino A.","family":"Gani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1902","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2011.02.009"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0145-y"},{"key":"ref3","first-page":"245","volume-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","year":"2020"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.10.013"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v6.i7.504"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1038\/nri3623"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v7.i3.377"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2013.12.001"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2010.08.015"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gox012"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3350\/kjhep.2012.18.1.1"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i1.1"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25752"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03701.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/895787"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.10748"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gow018"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21907"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/6170243"},{"key":"ref21","first-page":"109","volume-title":"Evaluation and treatment of esophageal varices in the cirrhotic patient","author":"Ashkenazi","year":"2013"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1272\/jnms.80.252"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2013.7.6.704"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28906"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-008-9096-8"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-010-9236-9"},{"key":"ref27","first-page":"406","volume-title":"EASL clinical practice guidelines for the management of patients with decompensated cirrhosis","year":"2018"},{"key":"ref28","first-page":"83","volume-title":"KASL clinical practice guidelines for liver cirrhosis: varices, hepatic encephalopathy, and related complications","year":"2020"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2009.00929.x"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1964.00280100009003"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840160607"},{"key":"ref32","first-page":"305","volume-title":"Non-invasive screening for esophageal varices in patients with liver cirrhosis","author":"Karatzas","year":"2018"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14036"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.4103\/2303-9027.187840"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.09.016"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044456"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-012-9353-8"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i10.3100"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2017.09.003"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-311735"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30220"},{"key":"ref42","first-page":"287","volume-title":"Carvedilol for prevention of variceal bleeding:a systematic review and meta-analysis","author":"Malandris","year":"2019"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)30934-2"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.09.031"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.disamonth.2018.02.001"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30054-7"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04746.x"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2018.084"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01356.x"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27006"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000013437"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.07.015"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21145"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/gou095"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30090-1"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1111\/den.12626"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2012.18.4.368"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2018.0039"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/5143013"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314653"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1177\/2050640615570148"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1016\/j.vgie.2018.08.004"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.02.029"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12452"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28318"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005680"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.4292\/wjgpt.v10.i1.1"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2017.0064"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001271"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.192039"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-966591"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12292"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.7454\/jpdi.v6i1.300"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000593472.50823.5f"}],"container-title":["Clinical and Molecular Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-cmh.org\/upload\/pdf\/cmh-2020-0022.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cmh.org\/journal\/view.php?doi=10.3350\/cmh.2020.0022","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cmh.org\/upload\/pdf\/cmh-2020-0022.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T06:59:15Z","timestamp":1602745155000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-cmh.org\/journal\/view.php?doi=10.3350\/cmh.2020.0022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,1]]},"references-count":74,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,10]]}},"URL":"https:\/\/doi.org\/10.3350\/cmh.2020.0022","relation":{},"ISSN":["2287-2728","2287-285X"],"issn-type":[{"value":"2287-2728","type":"print"},{"value":"2287-285X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,1]]},"assertion":[{"value":"2020-01-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}