Published online Mar 27, 2019. doi: 10.4254/wjh.v11.i3.250
Peer-review started: December 3, 2018
First decision: January 8, 2019
Revised: February 20, 2019
Accepted: February 26, 2019
Article in press: February 27, 2019
Published online: March 27, 2019
Gastric varices (GV) have different physiology and clinical characteristics compared to oesophageal varices (OV). There is little information about the management of GV. Most part of the recommendations is extrapolated from studies where the majority of participants had OV. Thus, most recommendations lack of strong evidence. This is a comprehensive review on all aspects of management of GV, i.e., primary, secondary prophylaxis and management of acute bleeding. The papers on which international societies’ recommendations are based are scrutinised in this review and areas of research are identified.
Core tip: This review focuses on an area in Hepatology which needs updating due to the recent contradictory recommendations from different international societies, i.e., American Association for the Study of Liver Disease, Baveno-VI and United Kingdom guidelines. Contradiction arises from lack of strong evidence. This comprehensive review analyses critically the key papers on which recommendations are based, and it also detects areas needing urgent research. There are also graphs and information which would help clinicians in their decision-making process.