Abstract: Objective This clinical trial was conducted to investigate the efficacy of endoscopic variceal ligation (EVL) and transjugular intrahepatic portal vein shunt (TIPS) in the treatment of patients with liver cirrhosis (LC) and complicated esophagogastric variceal bleeding (EVB) . Methods 85 patients with LC and complicated EVB were enrolled in this study between March 2019 and January 2022, and 42 patients in control group received EVL and 43 patients in observation group received TIPS after EVL. All patients were followed-up for 6 months. The portal vein pressure gradient (PPG), portal vein pressure (PVP) and portal vein flow velocity (PVFV) were detected by ultrasonography, and serum lipid peroxide (LPO), motilin (MTL) and gastrin (GAS) levels were determined by ELISA. Results The fatality rates after first bleeding were 9.3% and 9.5%(P>0.05) in the observation and control groups; there was no significant differences as respect to the hemostasis time and blood transfusion volume between the two groups (P>0.05), while the hospital stay in the observation group was(12.8±2.6)d, much longer than in the control; one month after operation, the PVFV in the observation group was (16.7±3.8)cm/s, much faster than , while the PPG and PVP were (9.1±1.4)mmHg and (19.6±2.3)mmHg, both significantly lower than in the control; serum LPO, MTL and GAS levels in the observation were (4.1±2.2)U/L, (202.4±22.7)ng/L and (76.3±8.4)μg/mL, all much lower than [(7.9±1.6)U/L, (256.8±26.1)ng/L and (115.6±10.9)μg/mL, respectively, P＜0.05) in the control; at the end of six-month follow-up, the incidence of re-bleeding in the observation groups was 7.7%, much lower than 31.6%(P＜0.05) in the control. Conclusion The patients with decompensated LC receive TIPS after EVL is efficacious in preventing re-bleeding after first EVB, which is worthy of further investigation.

Key words: Liver cirrhosis, Esophagogastric variceal bleeding, Endoscopic variceal ligation, Transjugular intrahepatic portal shunt, Re-bleeding, Therapy