Both doctors and patients have to face various contradictions in the treatment of portal hypertension: 1, hepatoprotective drugs: there are many hepatoprotective drugs in Chinese and Western medicine, all claiming to be effective, but after using them, they all find that their effects are limited, and a number of them are not obvious. 2, antiviral therapy: domestic and imported varieties are becoming more and more expensive, and various guidelines emphasize their importance, can really destroy the hepatitis virus in the liver cells without affecting the liver cells? In the human is not yet able to deal with all viruses today anti-hepatitis virus so effective? Is it really or…? Is it related to the malignancy of hepatocytes? Nanjing Gulou Hospital General Surgery Department Xie Min 3, hemostatic drugs: bleeding to use hemostatic drugs, but many patients with thrombosis in the portal vein is a contraindication to the use of hemostatic drugs. To use or not to use? When to use? How much to use? How to use? 4.Anticoagulants or thrombolytic drugs: In principle, these drugs are needed for thrombosis, but are they really effective? Is it really necessary to use these drugs when portal vein thrombosis occurs? Is it possible for these drugs to cause gastrointestinal bleeding? 5. Conditioning: Liver disease and hypersplenism are contraindications to all surgical procedures, and it is safest to operate after conditioning, but there is a great possibility that the condition will change during conditioning, and often the condition will not reach the surgical standard before another hemorrhage occurs, leading to further deterioration, and the timing of surgery will be lost in hesitation. Open early or late? Large open or small open? 6.Surgical procedures: surgical procedures such as shunt, cut-off, flow reduction, liver transplantation, etc., each has its own advantages and disadvantages, how to choose? How to sort? 7.Treatment options: The treatment of portal hypertension is now endoscopic (sclerosis, ligation), interventional (shunt, embolization), surgical (shunt, dissection, flow reduction, liver transplantation), and clinical research in various specialties is endless. Surgical or conservative? Which specialty? Which method to use? When to treat? 8. Treatment goals: eliminate cirrhosis and/or liver fibrosis and/or all types of hepatitis? Prevent rebleeding? To maintain the status of the liver? Personal experience: conditioning treatment in the absence of surgical complications (gastrointestinal bleeding and/or hypersplenism), surgical treatment in the presence of surgical complications, endoscopic treatment in the presence of bleeding, interventional treatment in the presence of unstable systemic condition, surgical treatment within three months after the first gastrointestinal bleeding if possible, selective flow dissection in the presence of portal vein thrombosis or sponge-like changes, and liver transplantation in the presence of acute and chronic liver failure. In case of acute and chronic liver failure, liver transplantation is the main treatment. Rational choice of medical treatment and multidisciplinary (MDT) consultation will make it possible to reasonably resolve conflicts in practice.