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目的 评价一期肝癌切除和门静脉高压症手术的疗效。 方法 回顾性分析１９９３ 年３月至１９９６ 年１２ 月同期进行肝癌切除和门静脉高压症手术３０ 例。 结果 术后１ 、２ 、３ 年绝对生存率分别为２２／２９（７６ ％ ） 、１７／２５（６８ ％ ） 、１０／２２（４６ ％ ） 。其中小肝癌分别为８／９（８９ ％ ） 、８／９（８９ ％ ） 、５／７（７１ ％ ） ；大肝癌和多发性癌分别为１４／２０（７０ ％ ） 、９／１６（５６ ％ ） 、５／１５（３３ ％ ） 。术后发生上消化道出血３例。随访中死亡１２ 例，死亡原因：肝癌复发７ 例，肝功能衰竭４ 例，上消化道大出血１ 例。其中２ 例为手术死亡，手术死亡率７ ％ 。 结论 该手术方便实用，但要注意适应症选择，小肝癌切除联合贲门周围血管离断疗效良好，大肝癌和多发性肝癌宜选用创伤小的术式。
Objective To evaluate the efficacy of primary hepatectomy and portal hypertension surgery. Methods A retrospective analysis of 30 cases of liver cancer resection and portal hypertension was performed from March 1993 to December 1996. Results The absolute survival rates at 1, 2, and 3 years after surgery were 22/29 (76%), 17/25 (68%), and 10/22 (46%), respectively. Among them, small HCCs were 8/9 (89%), 8/9 (89%), and 5/7 (71%) respectively; large HCC and multiple cancers were 14/20 (70%) and 9/16 (56) respectively. %), 5/15 (33%). Upper gastrointestinal bleeding occurred in 3 cases. Twelve patients died during follow-up. The cause of death was recurrence of hepatocellular carcinoma in 7 cases, liver failure in 4 cases, and upper gastrointestinal bleeding in 1 case. Two of these cases were surgical deaths and the operative mortality rate was 7%. Conclusions The operation is convenient and practical, but attention should be paid to the choice of indications. The effect of resection of small hepatocellular carcinoma combined with pericardial blood vessels is good, and it is advisable to use minimally invasive surgery for large hepatocellular carcinoma and multiple hepatocellular carcinoma.