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MediumGastroenterologyCirrhosis and variceal bleeding prophylaxisau-amcau-racp

A 45-year-old man with chronic alcohol use presents with jaundice, ascites and pedal oedema. He has spider naevi and palmar erythema. Ultrasound shows a nodular liver with splenomegaly and ascites, consistent with cirrhosis. Which of the following is the most important initial measure to reduce his risk of variceal haemorrhage?

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