1.What are the most dangerous complications of cirrhosis? The common complications of cirrhosis include upper gastrointestinal bleeding, hepatic encephalopathy (liver coma), primary liver cancer, ascites, infection, and hepatorenal syndrome. Upper gastrointestinal bleeding is the most dangerous complication. According to statistics, rupture of esophagogastric varices caused by portal hypertension in cirrhosis is the first direct cause of death in patients with cirrhosis. The mortality rate of its first bleeding is more than 20%; the rate of recurrent bleeding within one year is 70%, and the mortality rate is as high as 33%. 2.Why is it necessary for cirrhotic patients to undergo gastroscopy? Patients with cirrhosis have a higher chance of developing esophagogastric fundic varices, portal hypertensive gastropathy, and peptic ulcers. Gastroscopy can visually and comprehensively clarify the nature of lesions, distribution of lesions, causes of bleeding, and predict the risk of ruptured esophagogastric fundic varices bleeding. This can be decisive for the physician to develop a targeted treatment plan. Especially when the patient has acute hemorrhage, gastroscopy results can avoid blind and wrong treatment. 3.What treatments are available for cirrhosis? The current treatment methods for cirrhosis are mainly drugs, surgery (including liver transplantation), endoscopy, vascular intervention, Chinese medicine, cell transplantation, radiofrequency ablation, etc. Treatment needs to follow the principles of individualization, standardization and systematization. Among them, liver transplantation is the only method that can achieve both primary and secondary treatment. 4.What treatment methods are available for ruptured esophagogastric variceal bleeding? Which one is better? Ruptured esophagogastric fundic variceal bleeding is the focus of cirrhosis treatment. Besides prophylactic treatment, it includes medication, endoscopic ligation/sclerotherapy injection, surgery, interventional shunt (TIPS), interventional flow dissection (PTO), triple-lumen, two-capsule tube, etc. It is not scientific to overstate or rely on a single treatment method. Each method has its own advantages and limitations, and the key is the need to choose the most reasonable method for the patient’s specific condition. In most cases, endoscopy, surgery, intervention, and drugs often complement each other in different stages of treatment. 5.How to treat hypersplenism? Hypersplenism is a common comorbidity in patients with liver cirrhosis. It destroys the blood system causing serious consequences such as coagulation dysfunction, anemia and decreased immunity, and drug and blood transfusion treatment is extremely ineffective. Treatment methods for hypersplenism include surgery, vascular intervention (splenic embolization), and non-vascular intervention (splenic radiofrequency ablation). 6.What patients with cirrhosis need to receive liver transplantation? Liver transplantation is mainly used for patients with end-stage liver disease, cirrhosis, liver failure, very poor liver function and portal hypertension with bleeding that cannot be cured by other therapies. Of course, liver transplantation has problems such as lack of liver source, high cost and potential risks. 7.Which cirrhotic patients are suitable for surgery? Is it beneficial to improve liver function? The main therapeutic goals of surgery other than liver transplantation are to remove the pathological spleen, correct hypersplenism, reduce portal vein pressure, and reduce or eliminate the risk of bleeding from ruptured esophagogastric fundic varices. Therefore, if there are no contraindications, patients with splenomegaly, hypersplenism, history of esophagogastric varices and ruptured bleeding, inappropriate or unwilling to undergo endoscopic/interventional treatment, and failed endoscopic/interventional treatment are suitable for surgery. The survival rates at 5 and 10 years are 94.1% and 70.7%, respectively, and the postoperative bleeding rates at 5 and 10 years are 6.2% and 13.3%, respectively, and the incidence of hepatic encephalopathy at 5 and 10 years are 2.5% and 4.1%, respectively. This type of surgery has a definite benefit on improving liver function because it removes the spleen, eliminates the phenomenon of “spleen blood theft” and increases the blood supply to the liver. 8.What is the biggest misconception in the treatment of cirrhosis? Unfortunately, the biggest misunderstanding in the treatment of cirrhosis comes precisely from doctors. Most doctors are able to follow the principles of standardized and individualized treatment, except for a few who abuse and exaggerate the effects of a certain treatment because of professional knowledge limitations or profit motive. Unfortunately, influenced by a variety of factors such as the patient, the specialty with which the physician is familiar, and hospital conditions, the importance of systematic treatment is sometimes overlooked, and insufficient attention is paid to the impact of current treatment on the choice of future treatment modalities. As a result, treatment can become quite difficult as the patient’s condition progresses.