目的　探讨非规则性肝切除及癌栓取除术治疗肝细胞癌 (HCC)合并门静脉癌栓 (PVTT)的价值。方法　 1987年 1月至 1996年 12月采用非规则性肝切除及癌栓取除术治疗HCC合并PVTT的病人 6 2例 ,其中 ,40例在术后联合肝动脉化疗 (HAC)和门静脉化疗 (PVC)。 5 9例随访 3年以上。结果　 6例在术后 3个月内死于肝、肾功能衰竭 ,5 6例术后恢复良好。术后 1、2、3年的复发率和生存率 ,在手术后应用HAC和PVC组分别为 46 2 %、5 9 0 %、79 5 %和 6 9 2 %、5 1 3%、30 8% ,在未化疗组分别为 80 0 %、90 0 %、10 0 %和 30 0 %、10 0 %、5 0 %。结论　非规则性肝切除和癌栓取除术是HCC合并PVTT有效的治疗方法 ,术后联合HAC和PVC可降低复发率、提高生存率 Objective To investigate the value of irregular hepatectomy and tumor thrombectomy in the treatment of hepatocellular carcinoma (HCC) combined with portal vein tumor thrombus (PVTT). METHODS: From January 1987 to December 1996, 62 patients with HCC and PVTT were treated with irregular liver resection and removal of tumor emboli. Among them, 40 patients were treated with combined hepatic arterial chemotherapy (HAC) and portal vein chemotherapy ( PVC). 5 9 cases were followed up for more than 3 years. Results Six cases died of liver and kidney failure within 3 months after operation, and 56 cases recovered well after operation. The recurrence rate and survival rate at 1, 2 and 3 years after operation were 46 2%, 590.0%, 79.5%, 699.9%, 513.8%, and 30.8% of the HAC and PVC groups after surgery. %, in the non-chemotherapy group, were 80%, 90%, 100%, and 30%, 10%, and 50%. Conclusion Irregular hepatectomy and tumor embolectomy is an effective treatment for HCC with PVTT. Postoperative combined HAC and PVC can reduce recurrence rate and improve survival rate.