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目的 介绍用肝门区域血管阻断法切除最大径１０～３０ｃｍ，且经病理证实的肝细胞癌９６例的经验。复发的相关因素和疗效。方法 用肝门务砭解剖法游离阻断相应血管如肝右叶或右叶多亚役切除阻断肝动脉（ＨＡ）和门静脉（ＰＶ）右支（５４例次），中叶切除阻断睡ＰＶ右前支和ＨＡ和ＰＶ左内支（１０例次）、左叶切除阻断ＨＡ和ＰＶ左支（１１例次），左外段切除阻断ＨＡ和ＰＶ左外支（１５例次）。结果 （１）手术死亡率３．１％；

Resection,recurrence and therapeutic effect of bulky hepatocellular carcinoma

Objective To present the experience in resection of bulky HCC by regional vascular occlusion at hepatic hilum,the factors related to recurrence and the therapeutic effect in 96 cases.Methods The correlative branches of HA and PV to the resecting hepatic lobe or segments were isolated and occluded before resection.Right branches of HA and PV were occluded for right lobectomy or multiple subsegments resection of the right lobe(54 times),right anterior and left medial branches of HA and PV occluded for middle lobe resection(19 times),left branches of HA and PV for left lobectomy and left lateral branches of HA and PV for left lateral segmentectomy(15 times).Results Operation mortality rate was 3 1%.Recurrence rate was 70 0%.and 5,3,2,1,year survival rates were 13 5%,33 3%,42 8%,85 1% respectively.Conclusion Regional vascular occlusion at hepatic hilum prolongs vascular occlusion time,increases resectability of bulky HCC,reduces blood loss and hepatocytic mass suffered from ischemia during resection,improves operation safety and living time for these very late HCC patients.Chemotherapy via HA and PV catheterization might prevent the recurrence from micrometastasis in 2 years after operation.Interferon injection probably could prevent the 2nd HCC from a new clone of hepatocytes.