Abstract: Objective The aim of this study was to summarize the experience about endoscopic management of cirrhotics with superior esophageal variceal bleeding(SEVB). Methods 25539 patients with gastroesophageal varices (GEV) were encountered in our hospital between January 2010 and January 2020, out of them, 12 patients(0.4‰)had SEVB and all underwent endoscopic management (urgent in 5 cases and non-urgent in 7 cases). Results The etiology of the 12 patients with SEVB included hepatitis B cirrhosis in 5 cases, hepatitis C cirrhosis in 4 cases, alcoholic liver cirrhosis in 2 cases and unknown cause cirrhosis in 1 case; 11 patients had obvious clinical manifestations, such as hematemesis, melena, hematochezia or peripheral circulation disorder; 5 cases had successful hemostasis immediately with urgent endoscopic management, and 6 of 7 had with non-urgent management(P>0.05); the endoscopic variceal ligation(EVL) therapy was done in 9 cases, sclerotherapy in 1 case, EVL combined with tissue glue injection in 1 case and EVL combined with sclerotherapy and tissue glue injection in 1 case; the adverse reactions occurred after endoscopic management in 7 cases; 8 patients were followed-up for (31.0±28.5)m, and 1 patient had recent rebleeding and 5 patients had long-term rebleeding; out of 7 patients followed-up after treatment, 1 patient had splenectomy and 2 patients had splenectomy and pericardial devascularization; the all-cause mortality in our series was 42.9%. Conclusion The EVL is the first choice for patients with SEVB with high immediate hemostasis, but a poor long-term prognosis. It is necessary to reduce portal hypertension in combination with other treatments to decrease the risk of long-term rebleeding and death.

Key words: Liver cirrhosis, Superior esophageal variceal bleeding, Endoscopic variceal ligation, Therapy