Recommendations: 1. Once the diagnosis of cirrhosis is clear, gastroscopy (EGD) is recommended to screen for esophageal and gastric varices (Class Ⅱa, Level C); 2. At EGD, esophageal varices can be classified as small or large (>5 mm), and when using a tertiary classification, the latter should include medium-sized varices. The presence of red signs (red raised lines or erythema) should be indicated (Class Ⅱa, Level C); 3. In patients with cirrhosis without varices, the use of non-selective beta blockers to prevent their development is not recommended (Class Ⅲ, Level ; 4. In patients with compensated cirrhosis, if there are no varices at the time of the first EGD, EGD should be reviewed within 3 years (Class I, Level C). If liver failure is determined, EGD needs to be performed immediately and reviewed annually (Class I, Level C); 5. In cirrhotic patients with small varices and no bleeding, if they meet the criteria for elevated risk of bleeding (Child B/C class or presence of red signs in varices), non-selective beta blockers should be used to prevent first variceal bleeding (Class Ⅱa, Level C); 6. Level C); 6. In cirrhotic patients with smaller varices and no bleeding who also do not meet the criteria for elevated risk of bleeding, non-selective beta blockers may also be used, although the long-term benefit is not clear (Class Ⅲ, Level ; 7. In cirrhotic patients with smaller varices and no bleeding who are not on beta blockers, the EGD should be reviewed within 2 years ( Class I, Level C). If there is evidence of liver failure, EGD should be performed immediately and reviewed annually (Class I, Level C); EGD follow-up is not mandatory for patients with small varices who are treated with beta blockers; 8. For patients with moderate/large varices who do not bleed but are at high risk for bleeding (Child B/C class or presence of red signs in varicose veins) A non-selective beta blocker (propranolol or nadolol) or EVL is recommended to prevent the first episode of variceal bleeding (Class I, Level A); 9. In patients with moderate/large varicose veins who do not bleed but are not at high risk of bleeding (Child A, no red signs), a non-selective beta blocker (propranolol or nadolol) is preferred; when EVL (Class I, Level A) should be considered when there are contraindications to beta blockers, intolerance or poor compliance with medication; 10. If the patient is taking a non-selective beta blocker, gradual adjustment to the maximum tolerable dose is required and EGD follow-up monitoring is not mandatory. If the patient is on EVL therapy, it is repeated every 1 to 2 weeks until the varicose vein is occluded. The first EGD monitoring should be done 1 to 3 months after occlusion and every 6 to 12 months thereafter to check for variceal recurrence (Class I, Level C); 11. Nitrates (alone or in combination with beta blockers), bypass surgery or sclerotherapy should not be used as primary prevention of variceal bleeding (Class Ⅲ, Level A); 12. Acute GI in patients with cirrhosis Bleeding is an acute condition that requires attention, rapid intravascular volume support and blood transfusion, and careful maintenance of hemoglobin at about 8 g/dL (Class I, Level ; 13, short-course (up to 7 days) prophylactic antibiotic use can be used in all patients with cirrhosis with GI bleeding (Class I, Level A); oral norfloxacin (400 mg BID) or intravenous ciprofloxacin (for those unable to take the drug orally) (Class I, Level A). For patients with progressive cirrhosis, intravenous ceftazidime (1g/d) is preferred, especially in those areas with a high prevalence of quinolone-resistant bacteria (Class I, Level ; 14. Once bleeding is suspected to be variceal bleeding, immediate treatment with drugs (growth inhibitors and their analogs octreotide and vapratide, terlipressin) needs to be continued for 3 to 5 days after the diagnosis is clear (Class I, Level Level A); 15. EGD is feasible within 12 hours to definitively diagnose and treat variceal bleeding, EVL or EVS (Class I, Level A); 16. TIPS is indicated in patients with uncontrolled variceal bleeding in the esophagus or who have recurred after combined drug and endoscopic treatment (Class I, Level C); 17. Balloon tamponade can be used as 17, balloon tamponade can be used as a palliative interim measure (up to 24 hours) in patients with uncontrolled bleeding pending the scheduling of more definitive therapies (e.g., TIPS or endoscopic treatment) (Class I, Level; 18, endoscopic tissue adhesive such as cyanoacrylate for endoscopic variceal occlusion is preferred in patients with variceal bleeding in the fundus, in addition, EVL (Class I, Level C) can also be considered. EVL may be considered (Class I, Level; 19, TIPS may be considered in patients with uncontrolled fundic variceal bleeding or recurrent bleeding after combined drug and endoscopic therapy (Class I, Level; 20, Patients with cirrhosis who survive active variceal bleeding require treatment to prevent recurrent variceal bleeding (secondary prevention) (Class I, Level A); 21, The combination of non-selective beta blockers and EVL is the best choice for secondary prevention of variceal bleeding (Class I, Level A); 22, Non-selective beta blockers should be adjusted to the maximum dose tolerated, EVL should be repeated every 1 to 2 weeks to know the venous occlusion, and the first surveillance EGD should be performed 1 to 3 months after venous occlusion and every 6 to The first surveillance EGD should be performed 1 to 3 months after the vein occlusion and repeated every 6 to 12 months to check for recurrence of varicose veins (Class I, Level C); 23. Child A or B patients with recurrent variceal bleeding despite combined drug and endoscopic therapy need to be considered for TIPS, and in specialized centers, Child A patients may also be considered for bypass surgery (Class I, Level A); 24, Patients eligible for transplantation need to be referred to a transplant center for evaluation (Class I, Level C). Recommendations for further research: Important areas of diagnosis and treatment of varicose veins and their bleeding deserve further research: 1. non-invasive markers that predict high risk of varicose veins; 2. the role of capsule endoscopy in the diagnosis of varicose veins and their bleeding; 3. the role of HVPG in guiding treatment; 4. the choice of HVPG measurement methods; 5. new therapeutic agents that have a greater effect on HVPG; 6. The best treatment modality for fundic varices and their bleeding.