Rescue therapy in variceal bleeding

What are the techniques available for rescue therapy in variceal bleeding ? 

Balloon tamponade is typically employed if EBL cannot be attempted because of patient instability, or if rebleeding occurs immediately after EBL. Transjugular intrahepatic portosystemic shunts (TIPSs) are indicated in the setting of rebleeding after EBL or for initial management of gastric variceal bleeding. In experienced centers, early TIPSs for esophageal variceal bleeding has been associated with a decrease in rebleeding and mortality in patients with Child-Pugh class C cirrhosis or class B with active bleeding.


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