Timing of Endoscopy in Cirrhotic Patients with Acute Variceal Bleeding

A total of 368 cirrhotic patients presenting with AUGIB that is highly suspected to be from AVB will be enrolled. They will be stratified according to the severity of liver function and hemodynamic status at admission, and randomly assigned at a 1:1 ratio into early (within 12 hours after admission) and delayed (within 12-24 hours after admission) endoscopy groups within each stratum. The primary outcomes include the rates of 5-day failure to control bleeding after admission and 6-week rebleeding. The secondary outcomes include 6-week mortality and incidence of adverse events.

Inclusion criteria

• patients with AUGIB which is highly suspected to be caused by gastroesophageal variceal rupture;
• patients with a diagnosis of liver cirrhosis based on imaging and pathology;
• patients and/or their relatives who sign informed consents;
• patients' age ≥18 years.

Exclusion criteria

• patients who have undergone endoscopy at other hospitals before admissions;
• patients' hemodynamics are unstable after resuscitation;
• patients with severe cardiovascular or cerebrovascular diseases or renal injury;
• patients who have taken anticoagulants or antiplatelet drugs within 2 weeks before admissions, or are diagnosed with severe hematological diseases;
• patients with human immunodeficiency virus or other acquired or congenital immune deficiency diseases;
• patients with mental illness;
• pregnancy.