Published online Mar 27, 2014. doi: 10.4254/wjh.v6.i3.130
Revised: February 11, 2014
Accepted: February 16, 2014
Published online: March 27, 2014
Core tip: This mini-review addresses endoscopic management principles for gastric variceal bleeding. Endoscopic variceal obliteration (EVO) with tissue adhesives is the currently accepted strategy for controlling bleeding and eradicating gastric varices (GVs). EVO is deemed better than both variceal ligation and sclerotherapy in randomized controlled trials. One unsettled issue with EVO is if routine reinjection is better than reinjection in case of rebleeding. The experience with combination treatments is still premature. For secondary prophylaxis, EVO, transjugular intrahepatic portosystemic shunt or beta-blocker use is recommended. Emerging use of EUS provides optimism of better diagnosis, improved classification, innovative management strategies and confirmatory tool for eradication of GVs.