The patient was a 56-year-old male with a 20-year history of hepatitis B. He presented with pain and discomfort in the right upper middle abdomen for six months, and vomited 500 ml of blood a month ago, and the bleeding stopped after intravenous hemostatic drugs. Ultrasound showed cholecystitis, gallbladder stones, gallbladder enlargement, cirrhosis, portal hypertension, splenomegaly; gastroscopy showed 3 varices in the middle and lower esophagus with surface red signs, diagnosing esophagogastric varices and portal hypertensive gastropathy. The following are his MRI pictures: we can see that his liver is covered with nodules and shrunken in size, there is a large stone in his gallbladder, and his spleen is significantly enlarged, the normal spleen is only the size of a fist, while his spleen is as big as a soccer. After preoperative preparation, he underwent a giant splenectomy, peripancreatic vascular dissection, and cholecystectomy. During surgery, 500 ml of ascites was seen in the abdominal cavity, the liver showed large nodular hepatic sclerosis with a hard texture, the spleen was 30*25*12 cm, and the splenic vein had a diameter of 2.0 cm. The blood vessels around the lower esophagus and fundus were heavily dilated, and the gallbladder was edematous with stones inside. The following is a photo of the resected spleen: the patient recovered well after surgery and has not had any further bleeding since discharge.