11. Preventing Rebleeding in 2010

Prevention of Rebleeding

  1. Roberto de Franchis MD, AGAF Professor of Gastroenterology Head
  1. Norman Grace MD, FACP, FACG Professor Lecturer Director1,
  2. Gin-Ho Lo MD Professor Director2,
  3. Frederik Nevens MD3,
  4. Tilman Sauerbruch MD Professor Chairman4,
  5. Peter Hayes MD, PhD Professor5,
  6. Candid Villanueva MD6 and
  7. Didier Lebrec MD7

Published Online: 17 NOV 2010

DOI: 10.1002/9781444393989.ch11

Portal Hypertension V: Proceedings of the Fifth Baveno International Consensus Workshop, Fifth Edition

Portal Hypertension V: Proceedings of the Fifth Baveno International Consensus Workshop, Fifth Edition

How to Cite

Grace, N., Lo, G.-H., Nevens, F., Sauerbruch, T., Hayes, P., Villanueva, C. and Lebrec, D. (2011) Preventing Rebleeding in 2010, in Portal Hypertension V: Proceedings of the Fifth Baveno International Consensus Workshop, Fifth Edition (ed R. de Franchis), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444393989.ch11

Editor Information

  1. Department of Medical Sciences, University of Milan, and Gastroenterology 3 Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico Mangiagalli and Regina Elena Foundation, Milan, Italy

Author Information

  1. 1

    Tufts University School of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA

  2. 2

    I-Shou University, Medical Education, Digestive Centre, E-DA Hospital, Kaohsiung, Taiwan

  3. 3

    Department of Liver and Pancreatic Disease, UZ Gasthuisberg KU Leuven, Leuven, Belgium

  4. 4

    Department of Internal Medicine I, University of Bonn, Germany

  5. 5

    University of Edinburgh, UK

  6. 6

    Gastrointestinal Bleeding Unit, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

  7. 7

    Inserm U773, Centre de Recherche Biomédicale Bichat-Beaujon CRB3, Université Denis Diderot Paris 7, and Department of Hepatology, Hôopital Beaujon, Clichy, France

Publication History

  1. Published Online: 17 NOV 2010
  2. Published Print: 14 JAN 2011

ISBN Information

Print ISBN: 9781444334494

Online ISBN: 9781444393989



  • rebleeding prevention;
  • preventing rebleeding in 2010;
  • beta-blockers, alone or combined with other drugs;
  • Baveno consensus conferences - non-selective beta-blockers (NSBBs), decreasing risk of recurrent variceal haemorrhage and mortality;
  • vasodilators, as isosorbide-5-mononitrate (ISMN) - increasing number of haemodynamic responders;
  • endoscopic injection sclerotherapy (EIS) - leading role in 1980s, in variceal rebleeding prevention;
  • EIS and EVL combination - synchronous or metachronous;
  • endoscopic variceal ligation and drugs vs. ligation alone;
  • combination of drugs vs. endoscopic variceal ligation and drug combination;
  • combination of EVL and NSBBs, as treatment of choice - preventing variceal rebleeding


This chapter contains sections titled:

  • Beta-blockers alone or combined with other drugs

  • Endoscopic therapy: endoscopic variceal ligation or combined with other endoscopic procedures

  • Drugs alone or with endoscopic variceal ligation?

  • Endoscopic variceal ligation alone or with drugs?

  • Transjugular intrahepatic portosystemic shunt versus endoscopic treatment

  • Rescue therapy: always TIPS? Treatment of poor candidates for TIPS

  • Secondary prophylaxis of variceal bleeding:

  • Role of surgery

  • The role of HVPG monitoring in secondary prophylaxis

  • References

  • Time to start secondary prophylaxis