The causes of postoperative upper gastrointestinal re-bleeding 1, the inherent limitations of surgery The main cause of portal hypertension is hepatic steatosis, and the current treatment of portal hypertension is basically aimed at bleeding, and postoperative hepatic steatosis, the fundamental factor causing portal hypertension, still exists, which is one of the fundamental causes of postoperative re-bleeding. 2, the factors in the surgical operation Menchie dissection, the scope and thoroughness of the dissection how, directly affect the surgical effect. The effect is inevitably different between skilled and unskilled. This is the reason why the effect of the same operation is different. 3, liver compensatory function Poor liver function is an important factor in early bleeding and high mortality. Patients with advanced hepatic sclerosis are often combined with coagulation mechanism disorder, which makes upper gastrointestinal bleeding more likely to occur. 4.Local factors Inflammation and erosion of the mucosa of the lower esophagus due to acid reflux can induce bleeding from ruptured esophageal varices, which has been disputed recently but is still controversial. It has been argued that elevated portal pressure is necessary for the occurrence of esophageal varices and ruptured bleeding, but it is not sufficient because many patients with portal hypertension combined with esophageal varices never bleed. This indicates that there may be local factors in addition to increased portal pressure. 5, other factors Alcohol abuse is a common cause of postoperative bleeding, in addition, various factors of increased intra-abdominal pressure, such as pregnancy, respiratory tract infection, and massive ascites, are also considered to be predisposing factors for esophageal variceal bleeding. Treatment options for upper gastrointestinal rebleeding 1.Firstly, internal hemostatic treatment Use of hemostatic drugs such as hemostatic minerals, hemostatic aromatic acid, growth inhibitors, and transfusion support. 2.Fiber gastroscopy treatment Local use of hemostatic drugs, sclerotherapy or ligature treatment of bleeding vessels, etc. 3. Interventional treatment such as TIPS (transjugular intrahepatic shunt) treatment. 4. If conservative medical treatment is ineffective for 24 hours, surgery should be implemented as soon as possible. Although secondary surgery increases the surgical difficulty of surgeons and requires higher surgical skills, surgery is still a fast and effective treatment for upper gastrointestinal bleeding after splenectomy with menchiectomy. Our surgical department has extensive experience in the surgical treatment of these patients.