Gastric Variceal Ligation Versus Gastric Variceal Obturation for Secondary Prophylaxis of Gastric Varices
Gastric Variceal Ligation Versus Gastric Variceal Obturation for Secondary Prophylaxis of Gastric Varices
The investigators establish a randomized controlled clinical trial, comparing the efficacy
 and prognosis of GVL and GVO in secondary prevention of GVs, especially in patients with
 portosystemic shunting, and exploring the endoscopic treatment selection of different types
 of GVs.

 Outcome expectations: Compared with glue injection, endoscopic ligation for secondary
 prevention of gastric varices is safe and effective, especially in patients with
 portosystemic shunting.
Gastric varices (GVs) is a common complication of portal hypertension, with an incidence of
 20%. Though the bleeding rate of GVs (25%) is lower than that of Esophageal varices (EVs),
 the mortality rate is higher due to greater GVs rupture and less space for endoscopic
 intervention. In addition, in 30% of patients with GVs, the possibility of treatment failure
 exists.

 Guidelines differ on endoscopic treatment for secondary prevention of GVs.Current studies
 suggest that EVL, due to its low incidence of complications, is suitable for GOV1, while it
 is still controversial for the treatment of gastric varices. Compared with glue, the
 advantage of ligation is that it can avoid serious complications caused by glue injection,
 such as ectopic embolization, large ulcer and sepsis. As there are few studies comparing GVL
 and GVO in secondary prevention of gastric varices, the treatment methods are different, and
 the treatment effect is controversial. In addition, the choice of treatment for different
 types of GVs needs further study.

 The investigators establish a randomized controlled clinical trial, comparing the efficacy
 and prognosis of GVL and GVO in secondary prevention of GVs, especially in patients with
 portosystemic shunting, and exploring the endoscopic treatment selection of different types
 of GVs.

 Outcome expectations: Compared with glue injection, endoscopic ligation for secondary
 prevention of gastric varices is safe and effective, especially in patients with
 portosystemic shunting.
Inclusion Criteria:

 -  Patients over 18 years of age；Past history of gastroesophageal variceal hemorrhage
 confirmed by an endoscopic examination

 Exclusion Criteria:

 -  Patients who are not suitable for endoscopic treatment judged by the clinician;
 Patients who are not suitable for the ligation treatment because of scar change by
 repeated glue injection; Patients with acute hemorrhage