Surgical treatment of portal hypertension is mainly aimed at upper gastrointestinal bleeding due to esophagogastric fundic varices in portal hypertension, and the consensus has been reached that for patients who have experienced upper gastrointestinal bleeding, surgical treatment should be the first choice if liver function is good due to the presence of a very high rate of rebleeding; for patients who have not experienced bleeding, drugs such as punarolol can be applied to reduce portal pressure and are not recommended Application of surgery for prophylactic treatment. Due to a series of problems after splenectomy, splenectomy is not recommended for patients with simple hypersplenism. Specific surgical procedures include the following, which should be selected according to the patient’s specific situation 1. Dissection: The scope of traditional dissection surgery includes peripancreatic vascular dissection, lower esophageal dissection and reanastomosis, and splenectomy. The advantage is that it is less invasive and can be performed in most hospitals, and the effect of early postoperative hemostasis is exact. However, because many hospitals in China are currently performing dissection surgery without performing lower esophageal dissection and reanastomosis, this has led to a high rate of postoperative rebleeding. In addition, the high incidence of splenic vein and portal vein thrombosis after splenectomy, resulting in impaired liver function in some patients, is also a problem that needs to be solved in this surgery. 2.Spleen-preserving and flow-cutting surgery: Splenoprotective and flow-cutting surgery is the latest treatment for ruptured esophagogastric fundic varices and bleeding in portal hypertension proposed by Prof. Zhu Jiye and Prof. Leng Xisheng of Peking University People’s Hospital in recent years. This surgery preserves the function of the spleen and reduces the incidence of portal vein thrombosis while performing peripancreatic vascular dissection. 3.Bypass surgery: It is a more ideal method to prevent and control hemorrhage because it can effectively reduce portal vein pressure by using the main trunk of portal vein system and its major branches to anastomose with vena cava and its major branches so that the higher pressure portal vein blood can be bypassed into vena cava. However, hepatic encephalopathy can occur in some patients after shunt surgery, and in some patients the shunt pathway is prone to thrombosis. At present, the more ideal way of shunt surgery is distal splenorenal shunt. 4.Liver transplantation: Liver transplantation is the most ideal surgical treatment for portal hypertension, which fundamentally relieves the cause of portal hypertension and has the most definite efficacy. However, due to the shortage of donor livers and the cost, most patients are unable to obtain a liver transplant. Given the risks associated with surgical procedures, patients with portal hypertension should choose an experienced hospital with a targeted approach to treatment rather than blindly undergoing surgery.