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  • Title: Prevention of recurrent haemorrhage.
    Author: Heller J, Sauerbruch T.
    Journal: Best Pract Res Clin Gastroenterol; 2007; 21(1):43-53. PubMed ID: 17223496.
    Abstract:
    Patients who survive a first bleeding episode of oesophageal varices have a high risk of rebleeding, which is associated with a high mortality rate. Prevention of a recurrent haemorrhage is therefore recommended. Patients who were not on a primary prophylaxis should be treated with non-selective beta-adrenoceptor antagonists, endoscopic band ligation or both. If beta-blockers are not tolerated or are contraindicated, patients should be treated with endoscopic band ligation. If these preventive strategies fail, transjugular intrahepatic portosystemic shunt (covered) or a small-diameter surgical shunt is indicated.
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