Prevention of Variceal Rebleeding by EUS-guided vs Conventional Endoscopic Therapy in Hepatocellular Carcinoma Patients

This study is comparing two methods for preventing re-bleeding from varicose veins in the esophagus or stomach (called varices) in patients with liver cancer (hepatocellular carcinoma). One approach uses conventional endoscopy (rubber band ligation or glue injection), and the other uses an ultrasound-guided endoscopic technique (EUS-guided therapy) that can target veins more precisely. **You may be eligible if...** - You have liver cancer (HCC) and recently had a variceal bleed (esophageal or gastric varices) that was successfully stopped by conventional endoscopy - The bleeding episode was within the past 4 weeks - You are able to provide written informed consent **You may NOT be eligible if...** - You are unable to give informed consent - You have health conditions that make any endoscopy unsafe - Your bleeding was not from varices - You have severe, uncorrectable blood clotting problems (INR above 1.5 or very low platelets despite transfusions) - You are in the terminal stage of illness Talk to your doctor to see if this trial is right for you.