Total laparoscopic splenectomy combined with pericardial devascularization has become an important surgical treatment for portal hypertension patients. Compared with the traditional open surgery, laparoscopic surgery has multiple advantages including precise operation, small trauma and quick recovery. Accurate preoperative evaluation, precise surgical operation and delicate perioperative management are still important parts in perioperative management of laparoscopic surgery. Preoperative reasonable and accurate individualized assessment, strict control surgical indications and contraindications are the important basis to ensure the perioperative surgery to be safe and rational; standardized and individualized surgical operation is the key for accurate vascular disconnection, reducing intraoperative bleeding and perioperative complications; the concept of fast-track surgery is conducive to the rapid recovery of patients with portal hypertension and reduce the operation related complications. Anticoagulant therapy is a safe and effective treatment to reduce portal vein thrombosis. It is an important task to strengthen the cooperation among different disciplines for the treatment of portal hypertension in the future.