Pre-operative examination: Laboratory tests: routine blood, routine urine and stool, fecal occult blood, liver and kidney function, electrolytes, coagulation function, routine before transfusion, blood type, AFP, etc.; Instrumental tests: electrocardiogram, chest X-ray, B ultrasound, upper abdominal scan and enhanced CT, etc. Postoperative complications and prevention 1. Hemorrhagic complications: intra-abdominal bleeding is one of the more dangerous complications after splenectomy, and the causes are mostly active bleeding and intra-abdominal blood leakage. These include bleeding from the tail vessels of the pancreas, the vessels of the splenic tip, the short vessels of the stomach, as well as bleeding from the diaphragm and splenic bed. It is mainly due to incomplete hemostasis of small bleeding points or dislodgement of ligature wires, and can also be due to the failure to effectively correct liver function and coagulation disorders due to insufficient preoperative preparation in time for emergency care, resulting in postoperative diaphragm and splenic bed oozing blood. 2. Infection: Early postoperative infections include pulmonary infection, subdiaphragmatic abscess, incisional infection, urinary tract infection, etc. The impact of infection varies according to the causative factors and patient condition. In addition to the general symptoms caused by infection (fever, local inflammation, etc.), there may also be local symptoms. Prophylactic application of broad-spectrum antibiotics before and after surgery can prevent the occurrence of infections. Routine intraoperative drainage of the splenic bed and postoperative management of the drains to keep them open can prevent the occurrence of postoperative subdiaphragmatic abscesses. If the patient presents with fever and left upper abdominal discomfort, the possibility of left subphrenic fluid and abscess cannot be ruled out, and further ultrasound and CT examination can be performed to confirm the diagnosis. For patients with subdiaphragmatic abscesses, localized puncture and drainage or tube drainage under ultrasound can be performed first, and antibiotics can be applied according to bacterial culture and drug sensitivity results. However, if the drainage is poor, incision and drainage should be performed promptly. Post-splenectomy aggressive infection is a unique infectious complication that occurs after total splenectomy, with an incidence of 0.5% and a mortality rate of 50%. Patients are at lifelong risk of developing the infection, but the majority of cases occur in the first 2 years after total splenectomy, especially in children, and the younger the child, the earlier the onset. 50% of patients have pneumococci as the causative organism, and others such as Haemophilus influenzae, Escherichia coli, and Streptococcus haemolyticus type B. The clinical features are insidious onset, which may start with mild flu-like symptoms, followed by high fever, headache, nausea, confusion, and even coma and shock within a short period of time, and death often occurs within a few hours to a dozen hours. It is often complicated by diffuse intravascular coagulation and bacteraemia. Given the morbidity of OPSI, total splenectomy in children (especially under 4-5 years of age) should be considered with caution. Once OPSI occurs, high-dose antibiotics are actively applied to control infection, and fluid and blood transfusions are used for anti-shock treatment. 3. Thrombosis and embolism: caused by elevated platelet count and increased blood viscosity after splenectomy. The platelet count rises 24 hours after splenectomy, and generally peaks 1 to 2 weeks after surgery, which is the high incidence of thrombosis. The most common is portal vein embolism, which can also occur in the retinal artery and mesenteric artery, causing the corresponding clinical manifestations. Portal vein thrombosis usually occurs 2 weeks after splenectomy and is characterized by dull epigastric pain, nausea, vomiting, bloody stools, elevated body temperature, increased white blood cell count and accelerated hematocrit. There are also cases without clinical manifestations. For the diagnosis of portal vein system thrombosis after splenectomy, the most effective methods are ultrasound and CT contrast-enhanced scan. Once the diagnosis is confirmed, it should be treated promptly, and fibrinolytic therapy can be tried if there is no contraindication. The portal vein can also be recanalized after the acute phase with anticoagulation, fasting, fluids and antibiotics. Heparin therapy can be used to prevent thrombosis after splenectomy. 4. Splenic fever: Patients often have fever lasting for 2-3 weeks after splenectomy, and generally the duration rarely exceeds 1 month, and the body temperature does not exceed 39℃. The duration and degree of splenic fever are directly proportional to the surgical trauma. Splenic fever is self-limiting fever, and only symptomatic treatment is required if other infectious complications and subphrenic infection can be excluded. 5. Pancreatitis: It is related to the damage to the pancreas during the intraoperative freeing of the splenic bed. If the postoperative serum amylase is elevated for more than 3 days and accompanied by symptoms, the diagnosis can be confirmed. Treatment with growth inhibitors is more effective. 6.Other rare complications: other complications such as hepatic encephalopathy and hyperuricemia have low incidence. The key to avoid these two complications is to carry out adequate preoperative preparation, improve liver function and reduce blood uric acid level as much as possible. III. Postoperative precautions 1. Observe the drainage tube and drainage flow, and routinely measure the changes in blood pressure, pulse and hemoglobin. Observe the condition of the drainage tube of the subdiaphragmatic splenic fossa. If there is a tendency of internal bleeding, blood and fluid should be transfused in a timely manner, and if there is indeed persistent hemorrhage, re-operation should be considered to stop the bleeding. 2. Splenectomy is a major stimulus to the intra-abdominal organs (especially the stomach), so resume eating 2 to 3 days after surgery. 3.Many patients with splenectomy have poor liver function, so they should be adequately supplemented with vitamins and glucose after surgery, and if liver coma is suspected, corresponding preventive and curative measures should be taken in time. 4. Pay attention to the changes of renal function and urine volume, and be alert to the occurrence of hepatorenal syndrome. 5.Routinely apply antibiotics after surgery to prevent and control systemic and subdiaphragmatic infections. If the platelet count rises rapidly to more than 50×109/L, splenic vein thrombosis may occur. If severe abdominal pain and bloody stools occur again, it indicates that the thrombosis has spread to the superior mesenteric vein, and anticoagulant therapy must be used in time, and surgical treatment is necessary. Post-operative diet: 1, the diet is generally 2-3 days after the recovery of gastrointestinal function, the initial liquid-based, gradually transition to semi-liquid, soft food, avoid eating irritating food and hard food; 2, to meet the supply of protein, often eat lean meat, eggs, chicken and fish, dairy products, should also eat some soybean products every day. 3.Must supply more iron-containing food than usual to meet hematopoietic needs and prevent anemia, such as animal liver, blood, lean meat, eggs, and marginal vegetables. 4.Provide a variety of vitamins, eat more vegetables, fruits, eggs, and dairy products, and maintain the daily intake of green vegetables and fruits. 5.Adequate sleep and regular life should be maintained after surgery.