Portal hypertension caused by diseases such as cirrhosis can easily lead to esophagogastric fundic varices. Under the effect of high pressure, the walls of the blood vessels in which varices occur become thinner. If the pressure on the veins is not weakened or even enhanced, the vessels may rupture at any time; once ruptured, it can lead to upper gastrointestinal hemorrhage and even death in serious cases. So when you have esophagogastric fundic varices, you must pay attention to prevent bleeding. If there is any sign of bleeding, it must be treated in time. Currently, there are three main types of treatment for esophagogastric fundic varices: medication, endoscopic treatment, and surgery. When esophagogastric fundic varices are found, they are usually treated with medications first, including visceral vasoconstrictors and other drugs. If medication is not effective, or if there is a high risk of bleeding from a ruptured vessel (or even if it has already bled), then the doctor will recommend the patient for endoscopic treatment. Endoscopic treatment is divided into two methods: ligation (EVL) and sclerotherapy (EVS). However, in a few patients, the condition may recur and bleed repeatedly after endoscopic treatment due to high portal vein pressure and poor circulation, in which case surgical treatment should be considered. Surgical treatment also includes flow disconnection surgery and bypass surgery. 1. Flow disconnection surgery Portal hypertension can cause enlargement of the spleen, causing a large amount of blood to pool in the spleen; this leads to poor circulation and a decrease in platelets and blood cells in the peripheral blood, which in turn causes hypersplenism and increases the risk of bleeding. Flow dissection surgery is also called splenectomy with peripancreatic vascular dissection. The removal of the spleen on the one hand can solve the problem of hypersplenism of the patient, thus reducing the risk of bleeding; on the other hand, the blood vessels connecting the peri-esophageal and internal veins are cut off, which can achieve the effect of controlling bleeding in the short term. However, the cut-off surgery does not solve the problem of high portal vein pressure, and the long-term treatment effect is not very good, and the patient may still have a recurrence of the disease after the surgery. 2.Bypass surgery Bypass surgery is to connect the portal vein system and the vena cava system, so that a part of the portal blood with high pressure flows directly into the vena cava, thus reducing the portal hypertension and achieving the purpose of controlling bleeding. However, after the bypass surgery, some of the toxins in the blood returning from the gastrointestinal tract enter the body circulation directly without being detoxified by the liver, and patients are prone to hepatic encephalopathy. It should also be noted that the surgery relieves the patient from bleeding, but it does not cure cirrhosis. Because cirrhosis is always present, some patients will still experience variceal bleeding. To prevent recurrence of the condition, patients need to be reviewed regularly. Liver function tests, coagulation tests, liver tumor markers (such as AFP, CEA, CA19-9) and imaging tests (abdominal ultrasound, CT, etc.) are usually required once every three to six months, plus a gastroscopy every year.