Indications: 1, left-sided portal hypertension or regional portal hypertension as little as possible, the effect is not good. 2.Prepare 2 gastroscopes in advance to prevent bleeding once it occurs, the other one should be prepared in advance with ligatures or tissue glue and sclerosing agent to buy time, and it is better to prepare a dual-channel endoscope, which can stop bleeding while flushing and keep a clear view. 3, esophagus unless there is a hemorrhage, try not to use tissue glue injection, because it is easy to lead to ectopic embolism; gastric fundus try to apply sclerosing agent (polyglactin) 4ml + tissue glue (each diameter of 1cm with 2, each 0.5ml, a total of 1ml, but for isolated large venous tumor can play more, otherwise easy to bleed, at this time can be used to 1.5ml, but the fundamental or to observe varicose veins Why not use iodine oil and hypertonic sugar, because iodine oil is easy to embolize and hypertonic sugar is not good to push. 4, after pushing, you can withdraw the needle core, but keep the cannula in the original position, you can properly retract outward, compress for 10-20s, observe whether there is bleeding, if there is bleeding, we should immediately push the tissue glue to close the bleeding, at this time, although we can see the tissue glue flowing outward, but generally will not stick to the cannula. 5.If it is grape-shaped, we should try to find the largest vein for injection, and we can find that the other ones will be reduced secondary to it. 6.After the varicose vein is injected, touch it with the cannula of the injection needle, and it will be fine if it becomes hard. If the injection place bleeds repeatedly, it is necessary to inject in other parts to stop the bleeding. 7.The ligature starts from the cardia first, spiral up, about 2cm apart, try not to ligature in the consent plane to avoid causing esophageal stenosis; 8.The ligature is generally installed so that the two lines are at 11 o’clock and 5 o’clock respectively; 9.The ligature should be rotated 180 degrees when the varicose vein is attracted to the full field of view, then release the attraction to make the ligature circle revealed, if it is not revealed, the gas can be injected properly; 10. The interval between ligation or sclerosis is 2 months, because it takes 2 months to make the ulcer heal; during this period, PPI and albumin should be applied to promote ulcer healing; 11, if bleeding occurs in the upper middle esophagus after ligation, in addition to the application of tissue glue injection, the simplest thing is to do injection or ligation in the cardia and fundus area to reduce the pressure bleeding in the upper esophagus; if it is still impossible to stop bleeding, then prepare a three-lumen two-bag tube. 12, direct vision mirror without locking the small button, adjust the position and then manipulate the injection needle with the left hand; 13, inject sclerosing agent after tying into the vein to see if it is in the vessel, sometimes even if part of it is under the mucosa, there is no need to be nervous, just think of it as compression of varicose veins.