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World J Gastrointest Endosc. Dec 16, 2021; 13(12): 628-637
Published online Dec 16, 2021. doi: 10.4253/wjge.v13.i12.628
Primary prophylaxis of variceal bleeding in patients with cirrhosis: A comparison of different strategies
Ângelo Zambam de Mattos, Carlos Terra, Alberto Queiroz Farias, Paulo Lisboa Bittencourt, Alliance of Brazilian Centers for Cirrhosis Care–the ABC Group
Ângelo Zambam de Mattos, Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
Carlos Terra, Department of Internal Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950000, Brazil
Alberto Queiroz Farias, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo 05403-000, Brazil
Paulo Lisboa Bittencourt, Gastroenterology and Hepatology Unit, Hospital Português, Salvador 40140-901, Brazil
Author contributions: All authors contributed to this paper with conception of the manuscript, literature review and analysis, drafting and critical revision of the manuscript, and approval of the final version of the paper.
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ângelo Zambam de Mattos, MD, MSc, PhD, Professor, Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, 245 Sarmento Leite Street, Porto Alegre 90050-170, Brazil. angmattos@hotmail.com
Received: June 19, 2021
Peer-review started: June 19, 2021
First decision: July 29, 2021
Revised: August 7, 2021
Accepted: November 22, 2021
Article in press: November 22, 2021
Published online: December 16, 2021
Core Tip

Core Tip: Variceal hemorrhage still is an important cause of death among patients with cirrhosis, and primary prophylaxis against variceal bleeding is of the utmost importance. Traditional non-selective beta-blockers, carvedilol or endoscopic variceal ligation are currently recommended for primary prophylaxis, and the superiority of one alternative over the others is controversial. This review will provide a comparison of the strengths and weaknesses of the different strategies for primary prophylaxis against variceal bleeding, so that practitioners make an informed decision when choosing among them.