Management of acute variceal bleeding: Updated APASL guidelines

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dc.authorid0000-0002-8218-5971
dc.authorid0000-0002-4202-4348
dc.authorid0000-0001-8243-6796
dc.authorid0000-0003-1247-437X
dc.authorid0000-0001-8704-4716
dc.authorid0000-0002-8909-2102
dc.authorid0000-0002-0544-5610
dc.contributor.authorLesmana, Cosmas Rinaldi Adithya
dc.contributor.authorShukla, Akash
dc.contributor.authorKumar, Ashish
dc.contributor.authorShalimar
dc.contributor.authorQi, Xiaolong
dc.contributor.authorGani, Rino Alvani
dc.contributor.authorDökmeci, Abdul Kadir
dc.contributor.authorÖrmeci, Necati
dc.contributor.authorSarin, Shiv Kumar
dc.date.accessioned2025-09-02T11:22:44Z
dc.date.available2025-09-02T11:22:44Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractAcute variceal bleeding (AVB) is a common life-threatening complication of portal hypertension (PHT), having a six-week mortality of 10%-20%. Major advances in the hemodynamic management, risk stratification, pharmacotherapy, endoscopy techniques, hemostatic devices and radiological interventions have led to improved management and outcome of AVB patients in the recent past. Therefore, the APASL Portal Hypertension Working Party, chose a panel of experts, primarily from the Asia–Pacific region, to identify important developments and controversial areas in the field of AVB. They discussed through a pre-defined and structured process, advances in the field and proposed updates to the previous APASL AVB guidelines. These included emphasis on safe transportation, defining time frames for AVB episodes and re-bleeding, reporting of clinical outcomes, optimizing early intervention strategies, pharmacotherapy, medical management, endoscopic therapies, and salvage modalities, including TIPS and self-expanding metal stents. The current updates also cover variceal bleeding in special populations and situations, the skill sets required for managing AVB patients, and the research priorities in the field. The updated guidelines are based on the latest evidence and incorporate emerging trends to provide a contemporary template for management of AVB in both patients with cirrhosis and non-cirrhotic portal hypertension.
dc.identifier.citationLesmana, C. R. A., Shukla, A. Kumar, A. Shalimar., Qi, X., Gani, R. A., Dökmeci, A. K., Örmeci, N., Sarin, S. K. (2025). Management of acute variceal bleeding: Updated APASL guidelines. Hepatology International, https://doi.org/10.1007/s12072-025-10894-4
dc.identifier.doi10.1007/s12072-025-10894-4
dc.identifier.issn1936-0541
dc.identifier.issn1936-0533
dc.identifier.pmidPMID: 40886248
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1007/s12072-025-10894-4
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1103
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorÖrmeci, Necati
dc.institutionauthorid0000-0002-8909-2102
dc.language.isoen
dc.publisherSpringer Nature Link
dc.relation.ispartofHepatology International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectGastrointestinal Hemorrhage
dc.subjectCirrhosis
dc.subjectPortal Hypertension
dc.subjectVasoactive Drugs
dc.subjectEndoscopy
dc.subjectVarices
dc.subjectNoncirrhotic Portal Fibrosis
dc.subjectEHPVO
dc.subjectCTP Score
dc.subjectMELD Score
dc.subjectHepatic Encephalopathy
dc.subjectTIPS
dc.subjectElla-Denis Stent
dc.subjectShunt Surgery
dc.titleManagement of acute variceal bleeding: Updated APASL guidelines
dc.typeArticle
dspace.entity.typePublication

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