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探讨第二肝门部肝癌切除合并主肝静脉结扎对自由门静脉压力（ＦＰＰ）的影响。方法在肝切除术前将埋植式给药装置（ＩＤＤＳ）置入门静脉主干，并通过ＩＤＤＳ对１０例病人之肝切除前后及术后１、３、５、７、１４、２１、２８天的ＦＰＰ进行直接动态测量。结果全组病人肝切除后均发生ＦＰＰ升高，以术后３～７天最为显著，之后逐渐下降；ＦＰＰ升高的幅度与肝硬化程度、肝切除范围、主肝静脉结扎情况之间存在密切联系；３例术后ＦＰＰ≥３５ｃｍＨ２Ｏ病人中，２例并发上消化道出血。结论第二肝门部肝癌切除合并主肝静脉结扎将导致ＦＰＰ的一过性升高，ＦＰＰ的升高是术后消化道出血的重要因素。
To explore the effect of resection of hepatic carcinoma of the second porta hepatis with main hepatic vein ligation on free portal pressure (FPP). METHODS: The IDDS was placed in the portal vein trunk before hepatectomy, and before and after 1, 3, 5, 7, 14, 21, and 28 days after hepatectomy with IDDS in 10 patients. FPP performs direct dynamic measurements. RESULTS: FPP increased in all patients after hepatectomy, which was the most significant from 3 to 7 days after operation, and then decreased gradually. There was a close correlation between the increase of FPP and the degree of liver cirrhosis, range of hepatectomy, and ligation of main hepatic veins. In the 3 patients with FPP ≥ 35cmH2O, 2 patients had upper gastrointestinal bleeding. Conclusion The resection of the second hepatic hepatic carcinoma combined with the main hepatic vein ligation will lead to a transient increase in FPP. The increase of FPP is an important factor in postoperative gastrointestinal bleeding.