Should we treat small varices?

 Cirrhosis and complications

Channel 4
English
Interactive Session
29 August 2020 15:30 - 17:00

The treatment of small varices which have not bled is a long-standing controversy in hepatology. While their presence indicates clinically significant portal hypertension, and thus, identifies patients who are risk for developing hepatic decompensation, the absolute risk of bleeding is considerably lower, as compared to large varices. Although current guidelines don’t provide a strong recommendation to treat these patients with non-selective beta blockers (NSBB), emerging evidence suggests that NSBB treatment may prevent variceal growth, and importantly, hepatic decompensation in compensated patients. In decompensated cirrhosis, the benefits of NSBB treatment have to be weighed against potential detrimental effects. Finally, the management of varices in patients with porto-sinusoidal vascular (PSVD) disease and portal vein thrombosis (PVT) is not particularly well-established, however, we encounter these patients in daily clinical practice.

In the case-based pro/con talks, the speakers are encouraged to address the following points:

  • Is there sufficient evidence to treat small varices with NSBB in compensated patients?
  • What are the potential benefits and risks of NSBB treatment in patients with decompensated cirrhosis?
  • NSBB treatment in PSVD and PVT - same-same or different?

Presentations

Title Time

Add to Calendar

Introduction
29 August 2020 15:30 - 15:33
Case 1: Compensated cirrhosis
29 August 2020 15:33 - 15:33
Pro
29 August 2020 15:33 - 15:42
Con
29 August 2020 15:42 - 15:51
Vote, discussion & audience questions
29 August 2020 15:51 - 16:01
Case 2: Decompensated cirrhosis
29 August 2020 16:01 - 16:01
Pro
29 August 2020 16:01 - 16:10
Con
29 August 2020 16:10 - 16:19
Vote, discussion & audience questions
29 August 2020 16:19 - 16:29
Case 3: PSVD/PVT
29 August 2020 16:29 - 16:29
Pro
29 August 2020 16:29 - 16:38
Con
29 August 2020 16:38 - 16:47
Vote, discussion & audience questions
29 August 2020 16:47 - 16:57
Conclusions
29 August 2020 16:57 - 17:00