A Randomized Controlled Study on the Treatment of Cirrhosis Combined With Hypersplenism

Secondary prevention: Inclusion Criteria: * Patients aged between 18 and 75 years * Patients who had recovered from an episode of VH or patients who had survived from acute VH and there was no bleeding for consecutive 5 days * Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination * Patients with hypersplenism and thrombocytopenia (platelets \< 100,000/µL). Exclusion Criteria: * Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding * Bleeding from isolated gastric or ectopic varices * Hepatocellular carcinoma or other malignant tumors * Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40% * Hepatic failure * Contraindications for PSE * Pregnancy and lactation * Inability to sign the informed consent. Primary prevention: Inclusion Criteria: * Patients aged between 18 and 75 years * Moderate to severe esophageal (and/or) gastric varices * Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination * Patients with hypersplenism and thrombocytopenia (platelets \< 100,000/µL). Exclusion Criteria: * Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding * Bleeding from isolated gastric or ectopic varices * Hepatocellular carcinoma or other malignant tumors * Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40% * Hepatic failure * Contraindications for PSE * Pregnancy and lactation * Inability to sign the informed consent. Acute bleeding: Inclusion Criteria: * Patients aged between 18 and 75 years * Acute esophageal (and/or) gastric varices rupture and bleed \<5 days * Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination * Patients with hypersplenism and thrombocytopenia (platelets \< 100,000/µL). Exclusion Criteria: * Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding * Bleeding from isolated gastric or ectopic varices * Hepatocellular carcinoma or other malignant tumors * Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40% * Hepatic failure * Contraindications for PSE * Pregnancy and lactation * Inability to sign the informed consent.