What are the key points of emergency splenectomy? 1, anesthesia: usually, simple and relatively simple splenectomy surgery, the choice of continuous epidural block anesthesia can be. For patients with emergency splenic rupture, the patients are often in pre-shock or shock state, generally in the preoperative input of a certain amount of plasma substitutes or components of blood transfusion (red blood cells), the operation should be carried out under general anesthesia, so that adequate oxygen can be given, at the same time, muscle relaxation, satisfactory exposure of the operating field to ensure the safety of the operation and general anesthesia is suitable for a variety of intraoperative resuscitation measures. 2, incision: the general choice of the left epigastric median incision or paramedian incision or left under the edge of the rib incision, according to the condition of the investigation can be appropriate to extend the incision, most surgeons are familiar with, can quickly into the abdomen, in line with the need for emergency surgical exploration. 3, exploration: into the abdominal cavity, should carefully explore the abdominal cavity organs. In case of splenic rupture and hemorrhage, the bleeding should be accurately and rapidly controlled after entering the abdomen. While suctioning off the free blood in the abdominal cavity, the blood clots should be probed to the place with the most blood clots to remove the blood clots, and the right hand should look into the spleen to separate the peritoneum outside and behind the spleen, and turn the spleen to the inner side, and then the right hand should be pinched or splenic forceps should be clamped on the tail of the pancreas, to block the splenic artery and vein blood flow temporarily, so as to understand the degree of the splenic injury, and then to classify the splenic injury and determine what kind of splenic surgical procedure to be used. The degree of splenic injury should be assessed to determine which splenic surgical method should be used. If there is still bleeding in the abdominal cavity even though the splenic clitoris is controlled, it may be combined with other organs and blood vessel injuries, which should be investigated and treated immediately, or the spleen that cannot be cured by splenectomy can be removed and then explored for the left kidney, the liver, and the gastrointestinal tract and its mesentery below the cardia, so as not to miss the injuries. 4. Removal of spleen: once the diagnosis of splenic rupture is clear and the ruptured spleen is not suitable to be preserved, the operator should try his best to hold the spleen out of the abdominal cavity with his hands, and then use splenic forceps or vascular forceps to clip the splenic tip under direct vision, and then remove the spleen without having to free the ligament and ligate the splenic artery first, so as to avoid time-consuming and excessive blood loss. If intra-abdominal hemorrhage is found to continue after exploration, and the binding of the perisplenic ligament can not be quickly lifted out of the abdominal cavity, in this case, the operator should use his left thumb to press the splenic vessels, and then lift the spleen out of the abdominal cavity after appropriate separation. During the operation, attention should be paid to the exact and thorough hemostasis of the ligature to avoid the occurrence of intraoperative hemorrhage caused by blind separation as well as side injuries such as stomach wall and pancreas. 5.Cleaning up the abdominal cavity: after splenectomy, active bleeding has been controlled in time, while cleaning up the abdominal cavity, further inspection should be made to see if there is any damage to other organs in the abdominal cavity, if there is no rupture of cavity organs, the blood recovered from the abdominal cavity can be re-infused. Postoperative drainage of the splenic fossa is routinely performed, and the drain should be removed early if there is no blood seepage and not much drainage in the postoperative period.