Objectives. Background: Hypersplenism associated with splenomegaly is a common complication in patients with portal hypertension caused by liver cirrhosis. Splenectomy, an alternative surgical intervention for these patients, has been determined to decrease portal pressure and improve thrombocytopenia and the liver function. Hypothesis: We hypothesize that surgery using azygo-portal devascularization and splenectomy is able to reduce the incidence of cirrhosis complications. Objective: To study the complications of hepatic cirrhosis in patients with hypersplenism secondary to portal hypertension before and after surgery using azygo-portal devascularization and splenectomy. Materials and methods. Materials and methods. 47 patients with cirrhosis of various etiologies and significant hypersplenism secondary to portal hypertension were examined before the operation and in the period from 6 months to 3 years after the operation by the method of azigoportal devascularization and splenectomy. We retrospectively analyzed the perioperative data and follow-up data of these patients. All patients were evaluated clinically, laboratory, imagistical and with esophago-gastro-dudenscopy. The incidence and severity of cirrhosis complications were studied: ascites syndrome, upper gastrointestinal bleeding and hepatic encephalopathy in patients with cirrhosis before the operation and in the period from 6 months to 3 years after the operation by the method of azigo-portal devascularization and splenectomy. Results. Before the operation, transitional ascites was noted in 45 (95.7%) patients, hepatic encephalopathy - in 31 (65.95%), upper gastrointestinal bleeding - in 28 (59.57%). After azygoportal devascularization and splenectomy, the frequency of all complications was statistically significantly reduced: ascites was registered in 8 (17.02%) patients, hepatic encephalopathy - in 10 patients (21.27%), upper gastrointestinal bleeding - in 5 (10.63%) patients. Varicose haemorrhage was the dominant etiology for upper digestive haemorrhage, the cause of 78% of upper digestive haemorrhage in cirrhotic patients included in the current study. In accordance with the classification of Forrest in the preoperative period: Forrest I; I, III, respectively: 8 (17.0%), 18 (38.3%) and 2 (4.3%) patients. After the operation, Forrest I and I, respectively: 3 (6.4%) and 1 patient (2.1%), Forrest III was not registered. A statistically significant decrease in bleeding frequency has been established, but with increased severity. Conclusions. After the operation by the method of azigoportal devascularization and splenectomy, the frequency of all complications of significantly decreased. Surgical approach to patients with cirrhosis of various etiologies and splenomegaly within the framework of portal hypertension complicated by severe hypersplenism benefits in the evolution of cirrhosis complications.