 To reflect practice in the real world, the endoscopic procedures were deliberately chosen to be carried out by regularly scheduled endoscopists rather than a small selected group of very experienced endoscopists. Varices were regarded as present or absent, with size recorded as either large 5 mm diameter or small 5 mm diameter based on subjective assessment of diameter.. Titrated sedation was undertaken in all patients with midazolam and fentanyl.. The size of the esophageal varices was measured in the distal 5 cm of the esophagus during withdrawal of the instrument. 