ScienceDaily (2010-06-09) -- A controlled trial conducted by researchers in Taiwan suggests that a combination of band ligation and nadolol may not be the most effective prophylaxis for first variceal bleeding resulting from cirrhosis.
Esophageal varices (EV，食管靜脈曲張) are abnormally enlarged veins in the esophagus(食道) that occur when portal hypertension (門靜脈高壓症) obstructs(阻斷) normal blood flow to the liver and causes the blood to back up into the esophageal vessels. Variceal(靜脈曲張) rupture(破裂) is a life-threatening condition. Approximately one third of cirrhotic patients with esophageal varices bleed, and the mortality rate associated with first bleed may be as high as 50%. 約有1/3的肝硬化病人有靜脈曲張出血，而加上第一次出血這個因素，其死亡率高50%。
The World Gastroenterology Organization (世界胃腸病學組織) practice guideline for esophageal varices in patients with cirrhosis and medium or large varices, but no hemorrhage (出血), recommends nonselective beta blockers (propranolol or nadolol) or endoscopic variceal ligation (EVL，內視鏡的靜脈曲張縫合術) for prevention of first variceal hemorrhage for patients at highest risk, and propranolol or nadolol for those who are not high risk or in whom EVL is not tolerated.
Gin-Ho Lo, Wen-Chi Chen, Huay-Min Wang, Ching-Chang Lee. Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding. Hepatology, 2010; : n/a DOI: 10.1002/hep.23617