HVPG-Guided Therapy Versus EVL Plus NSBB in Second Prophylaxis of Esophageal Variceal Bleeding

A Single-center Randomized Controlled Study of Secondary Prophylaxis of Cirrhosis Related Esophagogastric Variceal Hemorrhage Treated With HVPG-guided Therapy or Standard Esophageal Variceal Ligation Plus Beta-blocker

A single-center randomized controlled study comparing endoscopic or interventional therapy guided by the hepatic venous pressure gradient (HVPG) , to standard endosopic variceal ligation plus nonselective beta-blocker therapy (NSBB) in patients with esophageal varices due to liver cirrhosis with a history of esophageal variceal hemorrhage.Primary study outcome of the study is variceal rebleeding episodes occurring within the first years after interventions. Second study outcomes of the study are hepatic encephalopathy occurrence, mortality occurrence, liver transplantation or other cirrhosis-related complications.

Inclusion Criteria:

• Liver cirrhosis diagnosed by clinical examination, imaging or biopsy;
• A previous history of variceal hemorrhage;
• Written informed consent.

Exclusion Criteria:

• Previous history of secondary prophylactic treatment;
• Contraindications to treatment of endoscopy, surgery and TIPS
• Severe cardiac, pulmonary or renal dysfunction;
• Lactating or pregnant;
• Malignancies;