40%, and it was reduced by 53% in p

40%, and it was reduced by 53% in patients with medium to large varices. Variceal ligation success is similar to that of beta-blockers are less invasive. The combination of nonselective beta-blockers and endoscopic band ligation is more effective than either therapy alone.
In patients with small varices that have not bled but have increased risk of hemorrhage , nonselective beta-blockers should be used for prevention of the first variceal hemorrhage. In patients with medium - large varices that have not bled and are not at high risk for hemorrhage, nonselective beta-blockers are preferred, and endoscopic variceal ligation should be considered in those with contraindications or intolerance to or nonadherence with beta-blockers. In patients with medium - large varices that have not bled but have a high risk of hemorrhage, nonselective beta-blockers or endoscopic variceal ligation may be recommended for prevation of the first variceal hemorrhage.
Beta-blockers decrease portal venous flow, increase portal resistance, and decrease portal pressure. Propranolol and are equally effective. Beta-blockers dosage should be titrated to produce a 25% reduction in the patients baseline heart rate or until the resting heart rate is 55 to 60 beats/minute.