Recently, we have come across many cases of cirrhotic patients with large spleen, hypersplenism, low white blood cells and platelets, and in some cases, esophagogastric varices. So they all come to ask for removal of the spleen on the grounds that it can remove the hypersplenism to raise white blood cells, platelets and treat anemia, and even prevent vomiting of blood and reduce ascites. I would say that this is the right treatment, and indeed it was once widely used and saved many patients. But medicine is not immutable, after all it is only a treatment. I ask my patients every time if you are here for a cure or a surgery. The answer is simple: to cure. Since this is the case, you should choose the appropriate method to solve the problem, balancing efficacy, risk and cost expenditure. First, the root of these conditions is cirrhosis, and cutting the spleen does not solve the root only control the symptoms and reduce the risk of spitting up blood, treating the symptoms but not the root cause. Secondly, for low leukocyte platelets, many people worry about easy infection and bleeding, but the reality is that such patients have very little chance of infection and bleeding because of this. This is because the coagulation and immune function is not determined by two indicators. Returning to the choice of treatment, we all now know that laparoscopic removal of the gallbladder is less invasive and faster to recover, so we are willing to choose it over open surgery when necessary. By the same token, spleen excision is a high-risk procedure, so if a simple and safe method can solve it why not choose it? We are no longer as fearful of the threat of hypersplenism as we once were, and patients can survive long term without intervention. Moreover, there are now interventional and gastroscopic methods to control hypersplenism and to prevent and treat bleeding, and surgery can only be considered if these methods are ineffective, and the patient’s pain and safety can be better protected. This is the recommended course of treatment according to current domestic and international treatment guidelines. Whether surgery or drugs, gastroscopy, interventions are all stopgap methods, the root cause of cirrhosis cannot be completely solved, so surgery, which is incomplete and risky, should not be the first choice at this time. Instead, we should use our strength in the treatment of cirrhotic hepatitis, including antiviral therapy, liver preservation therapy, and liver transplantation if liver failure is a condition. The right way is to choose the right treatment at the right time.