<prompt> The primary therapy to prevent oesophageal varices is :Surgical approachesSclerotherapyTIPPSShunt operation  <response>: The treatment of patients with varices that have never bled is usually referred to as prophylactic therapy eg, prophylactic sclerotherapy or prophylactic propranolol. By convention, procedures performed on patients who have bled previously are referred to as therapeutic eg, therapeutic shunts. Prophylactic therapy is of value, since the moality rate of variceal bleeding is high 25, the risk of bleeding in patients with varices is relatively high 30, and varices can often be diagnosed before the initial episode of bleeding. Ref :Jarnagin W.R. 2010. Chapter 24. Liver Poal Venous System. In G.M. Dohey Ed, CURRENT Diagnosis Treatment: Surgery, 13e. 