To evaluate the efficacy and safety of endoscopic treatment for patients with anastomotic varices(AV)and explore the optimal treatment.

Eight patients with AV were enrolled. These patients were diagnosed by endoscopy from 2006 to 2020 in our center. Clinical features, endoscopic findings, treatment methods, adverse events and follow-up data were analyzed retrospectively.

Of the 8 patients, 4 had cavernous transformation in portal vein, and 1with liver cirrhosis. Hematemesis and melena were the most common initial symptom. During endoscopic examination, active bleeding in 2 cases and positive red color signs in other 3 cases were found. Five patients received endoscopic treatment. Three cases were treated with endoscopic cyanoacrolate injection (ECI), one with endoscopic injection sclerotherapy (EIS), and one with endoscopic variceal ligation(EVL). Immediate hemostasis rate was 100% post-endoscopic treatment for anastomotic variceal bleeding . Five-day treatment failure ratio was 20% . Six-week mortality after endoscopic treatment for anastomotic variceal bleeding was 0. The only adverse event was fever in one patient. During the follow-up period, one rebleeding case died of failure of conservative treatment for rebleeding.

AV bleeding is rare and has the characteristics of difficult diagnosis, large volume of bleeding, difficult hemostasis, and poor prognosis. Endoscopic treatment of AV bleeding is feasible, safe, and effective. The recurrent bleeding rate of this disease is not satisfied, endoscope follow-up should be emphasized. If rebleeding occurring, endoscopic treatment or interventional treatment should still be used.