Abstract: Objective The paper aimed to investigate the risk factors of rebleeding in hepatitis B liver cirrhotics with esophageal varices bleeding (EVB) after endoscopic variceal ligation (EVL). Methods 178 patients with hepatitis B liver cirrhosis (LC) with EVB were enrolled in our hospital betweenApril 2016 and October 2019, and all underwent EVL after hemostasis. A Nomogram model was established to predict the risk factors of rebleeding after multivariate Cox Logistic analysis was done. Results 12 (6.7%)patients died out of the 178 patients with EVB, and 166 patients received successful EVL in our series; at the end of 12 to 54 month follow-up, 27 patients(16.3%) had rebleeding of esophageal varices; at presentation, the peripheral blood hemoglobin and serum albumin levels in the 27 patientswith rebleeding were significantly lower than, while the fasting plasma glucose (FPG) and HbA1c levels were significantly higher than those in 139 patients without(P<0.05);the checked-up after hemostasis showed that the diameters of portal and splenic veins in patients with rebleeding were significantly wider than those in without (P<0.05); the Cox risk model analysis showed that the Child-Pugh class(95%CI=1.125-3.439, HR=1.967, P=0.018), ascites (95%CI=1.754-2.329, HR=2.021, P=0.000), HbA1c(95%CI=1.173-1.921, HR=1.501, P=0.001), FPG(95%CI=1.379-3.152, HR=2.085, P=0.000) and hepatic diabetes (95%CI=1.321-2.945, HR=2.076, P=0.006) were the independent risk factors for rebleeding after EVL; the Nomogram model was established based on the Cox analysis, and the ROC analysis showed that the area under the ROC (AUC) by theNomogram was 0.804(SE=0.053, 95%CI=0.700-0.907, P=0.000), with the sensitivity of 0.857 and the specificity of 0.565, in predicting rebleeding after EVL. Conclusion The incidences rate of rebleeding in LC patients with EVB after EVL is higher, and among others, the hepatic diabetes might be the important risk factor for rebleeding in this setting, which should be dealt with appropriately.

Key words: Liver cirrhosis, Esophageal varices bleeding, Endoscopic variceal ligation, Hepatic diabetes, Rebleeding