Abstract: Objective The aim of this study was to investigate oral maintaining treatment of propranolol after endoscopic variceal ligation (EVL) and somatostatin combination for emergent hemostasis in patients with esophagogastric variceal bleeding (EVB). Methods 116 cirrhotics with EVB were admitted to our hospital between January 2021 and December 2023, and were randomly divided into control (n=57) and observation (n=59) groups. All patients in the two groups underwent EVL and intravenous administration of octreotide for emergent hemostasis, and those in the observation received oral propranolol for maintaining treatment after operation. Portal vein flow (PVF) and splenic vein flow (SVF) were detected by ultrasonography, and hepatic venous pressure gradient (HVPG) was calculated after transjugular vein intubation. Plasma prothrombin time (PT) and fibrinogen (FIB) levels were routinely obtained. Results One week after treatment, the hemostasis rate in observation and control group were 94.9% and 96.5% (P>0.05), and three patients died in the observation and 2 died in the control; there were no significant differences as respect to bleeding cessation times [(63.5±2.1)vs. (62.3±3.6)h], blood transfusion [(3.9±0.8)U vs. (4.1±1.2)U], hospital stay [(10.4±1.7)d vs. (10.5±2.9)d] and medical costs [(10.8±2.0)thousand yuan vs. (10.8±2.0)thousand yuan] between the two groups (P>0.05); after treatment, PVF, SVF and HVPG in the observation were (541.5±108.6)ml/min, (289.7±53.4)ml/min and (13.5±3.1)mmHg, all significantly lower than [(616.4±112.7)ml/min, (306.4±56.3) ml/min and (14.6±3.8)mmHg, respectively, P＜0.05] in the control; plasma PT was (14.1±1.1)s and FIB levels was (2.7±0.8)g/L, both not much different as compared to [(14.0±1.2)s and (2.8±0.6)g/L] in the control (P＜0.05); the 3-month and 6-month re-bleeding rates in the observation group were 5.4% and 10.7%, both not significantly different compared to 7.3% and 14.6% in the control group (P>0.05). Conclusion Oral maintaining treatment of propranolol after emergent hemostasis in patients with EVB could reduce portal hypertension, which might reduce re-bleeding and needs long-term investigation.

Key words: Liver cirrhosis, Esophagogastric variceal bleeding, Endoscopic variceal ligation, Somatostatin, Propranolol, Therapy, Re-bleeding