【Abstract】Objective To evaluate the liver reserve function grading in the risk assessment of splenectomy and pericardial devascularization with portal hypertension and liver cirrhosis. Methods A retrospective analysis was made on the clinical data of 47 patients with viral hepatitis cirrhosis and portal hypertension. From March 2009 to November 2016, they underwent splenectomy and pericardia devascularization in the department of hepatobiliary surgery, The Second Affiliated Hospital of Xi'an Jiaotong University. Preoperative indocyanine green retention test was used to divide the patients into Group A (n=28) ICG R15＜30%, Group B (n=14) ICG R15 30%50%，Group C (n=5) ICG R15＞50%. Univariate analysis of variance (ANOVA) was used to compare the indexes of ChildPUGH grading, blood routine, coagulation series, liver function, peritoneal drainage, and complications post operation. Results The total bilirubin, direct bilirubin, peritoneal drainage volume on the third day post operation, the number of hepatic encephalopathy and death cases were significantly increased in group C compared with the other two groups (P＜005). ConclusionAccurate preoperative assessment of liver function is important to determine the risk and prognosis of splenectomy. On the basis of childpugh classification, indocine green liver reserve function could be examined to determine liver reserve function. ICG R15＜30% suggested low risk of operation. ICG R15 30%50% is medium risk, and ICG R15 ＞50% or Child grade C is high risk. The high risk group have higher incidence of postoperative complications such as liver dysfunction, hepatic encephalopathy, and abdominal hemorrhage. Liver transplantation was the better choice.