Abstract: Objective To explore the diagnostic value of Endoscopic Ultrasound (EUS) for esophagogastric varices in patients with hepatitis B-induced cirrhosis and evaluate the therapeutic effect of endoscopic variceal ligation (EVL) using EUS. Methods Between January 2020 and June 2022, 67 patients with hepatitis B-related cirrhosis and esophagogastric varices who received EVL treatment at our hospital and regularly underwent endoscopic follow-up were included. The patients were grouped based on whether they experienced variceal rebleeding before the follow-up. The observation group (n=31) had variceal rebleeding, while the control group (n=36) did not. EUS parameters and biochemical indicators were compared between the two groups. Results The detection rates of esophageal perforating veins, gastric perforating veins, and paracholedochal veins in the observation group were 58.1%, 64.5%, and 61.2%, respectively, which were significantly higher than those of 30.1%, 27.7%, and 22.2% in the control group (P<0.05). The total cross-sectional area, diameter of the left gastric vein, superior mesenteric vein, splenic vein, and portal vein in the observation group were (0.7±0.1) cm², (6.4±0.3) mm, (13.3±0.8) mm, (14.9±0.7) mm, and (17.16±0.53) mm, respectively, which were significantly higher than those of (0.4±0.1) cm², (5.1±0.2) mm, (9.9±0.7) mm, (12.6±1.0) mm, and (14.3±0.3) mm in the control group (P<0.05). The thickness of variceal wall in the observation group was (0.5±0.1) mm, which was significantly lower than that of (0.7±0.1) mm in the control group (P<0.05). Platelet count and albumin level in the observation group were (127.0±40.1) ×10⁹/L and (28.8±5.2) g/L, respectively, which was significantly lower than those of (141.2±22.5) ×10⁹/L and (34.1±9.6) g/L in the control group (P<0.05). The prothrombin time in the observation group was (12.9±2.6) s, which was significantly higher than that of (12.9±2.6) s in the control group (P<0.05). There was no significant difference in total bilirubin and direct bilirubin between the two groups. Binary logistic regression analysis revealed that the presence of esophageal perforating veins (OR=1.66, P=0.011, 95%CI:1.24-2.48), gastric perforating veins (OR=1.70, P=0.014, 95%CI:1.36-2.92), increased total cross-sectional area of varices (OR=2.40, P=0.021, 95%CI:1.01-5.16), enlarged splenic vein diameter (OR=2.10, P=0.028, 95%CI:1.10-4.40), widened portal vein diameter (OR=2.40, P=0.026, 95%CI:1.12-4.58), and prolonged prothrombin time (OR=1.80, P=0.011, 95%CI:1.75-2.70) were risk factors for variceal rebleeding in patients with esophagogastric varices. Thinner (thicker Please check) variceal wall thickness (OR=0.66, P=0.031, 95%CI:0.22-0.81) was a (risk)protective factor (for) against rebleeding. Conclusion EUS has significant advantages in assessing esophagogastric varices in cirrhotic patients and can effectively evaluate the therapeutic effect of EVL and predict bleeding risk.

Key words: Cirrhosis, Esophageal and gastric varices, Endoscopic ultrasonography, Esophageal variceal ligation, Risk factors