Secondary prevention:  Inclusion Criteria:  Patients aged between 18 and 75 years Patients who had recovered from an episode of VH or patients who had survived from acute VH and there was no bleeding for consecutive 5 days Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination Patients with hypersplenism and thrombocytopenia (platelets < 100,000/µL).  Exclusion Criteria:  Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding Bleeding from isolated gastric or ectopic varices Hepatocellular carcinoma or other malignant tumors Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40% Hepatic failure Contraindications for PSE Pregnancy and lactation Inability to sign the informed consent.  Primary prevention:  Inclusion Criteria:  Patients aged between 18 and 75 years Moderate to severe esophageal (and/or) gastric varices Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination Patients with hypersplenism and thrombocytopenia (platelets < 100,000/µL).  Exclusion Criteria:  Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding Bleeding from isolated gastric or ectopic varices Hepatocellular carcinoma or other malignant tumors Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40% Hepatic failure Contraindications for PSE Pregnancy and lactation Inability to sign the informed consent.  Acute bleeding:  Inclusion Criteria:  Patients aged between 18 and 75 years Acute esophageal (and/or) gastric varices rupture and bleed <5 days Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination Patients with hypersplenism and thrombocytopenia (platelets < 100,000/µL).  Exclusion Criteria:  Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding Bleeding from isolated gastric or ectopic varices Hepatocellular carcinoma or other malignant tumors Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40% Hepatic failure Contraindications for PSE Pregnancy and lactation Inability to sign the informed consent.