Brief description of the case: male, 62 years old, hospitalization number 4343396. Chief complaint: recurrent gastrointestinal hemorrhage for more than two years. Past and present history: In 1992, the common bile duct was damaged during cholecystectomy, and after intraoperative bile duct repair, he had repeated biliary stricture infections, and then underwent biliary-intestinal anastomosis 3 months after surgery, after which he still had repeated episodes of cholangitis. More than two years ago, gastrointestinal hemorrhage occurred several times without any obvious cause, and the bleeding volume was around 1000 ML, all of which were treated with endoscopic sclerotherapy to control the bleeding, and the endoscopist found that the varices of gastric fundus were increasing and enlarging, while the esophageal varices were not obvious. Diagnosis at the time of referral: 1. regional portal hypertension with ruptured bleeding fundic varices, 2. hemorrhagic shock, 3. hypersplenism, 4. after multiple sclerotherapy, 5. after cholecystectomy, 6. after biliary-intestinal anastomosis. At the time of referral: Hb31g/L,plt35,000, mild abnormal liver function, BP40~55/20~30mmHg, HR100 beats/min, clear, indifferent, repeatedly solving blood stool with large amount of clots within 3 days. Intraoperative findings: FPP 32cmH2O, ascites 500ml, old blood was seen in the intestine, the spleen was obviously enlarged with extensive adhesions to the surrounding organs, perigastric veins were angered, and the posterior wall of the stomach was densely adherent to the tail piece of the pancreatic body (about 6cm in diameter), in which a 1CM diameter penetrating branch vein was separated, and no large penetrating branch vein was seen in the esophagus. A giant splenectomy and selective peripancreatic vascular dissection were performed, preserving the giant left gastric vein. Intramural dissection was not performed due to intraoperative blood pressure instability, failure to measure Hb in venous blood three times in a row, shortage of blood sources, inconspicuous esophageal varices, and extensive adhesions caused by multiple intra-abdominal surgeries. He was discharged from the hospital on February 17, 2012 after recovery from FPP 33 cmH2O and Hb 41 g/L. No abnormality was seen at follow-up until December 2013.