目的通过８６例特大原发性肝癌的临床追踪分析，以探讨其手术切除指征和疗效。方法１９８５年１月至１９９６年６月，共采用手术切除治疗特大原发性肝癌８６例，其中规则性肝叶切除４６例，不规则肝叶切除４０例。统计术中出、输血量。术后观察腹腔引流量、补液天数、住院天数，随访并发症发生率及生存时间。结果手术死亡率３４８％，术后并发症的发生率为３１４％。手术死亡率和术后并发症发生率与术前白蛋白较低或γ－球蛋白升高以及肝切除量有明显关系。但如果术前肝功能良好，争取一期切除后，１、３、５年生存率仍可分别达到５８８２％、３５２９％和１７６４％。结论术前肝功能正常的特大原发性肝癌，肿瘤与肝组织分界清楚即应争取手术切除。术后辅以其它治疗，可以进一步提高疗效。 Objective To analyze the clinical follow-up analysis of 86 cases of primary hepatocellular carcinoma to explore the indications and efficacy of surgical resection. Methods From January 1985 to June 1996, a total of 86 cases of extrahepatic hepatocellular carcinoma were treated with surgical resection, including 46 cases of regular hepatectomy and 40 cases of irregular hepatectomy. Statistics of intraoperative blood transfusions. Postoperative abdominal drainage, rehydration days, hospital stay, follow-up complications and survival time. Results The operative mortality was 348%, and the postoperative complication rate was 314%. The incidence of operative mortality and postoperative complications was significantly associated with lower preoperative albumin or elevated γ-globulin and hepatectomy. However, if the preoperative liver function is good, after one-stage resection, the 1-, 3-, and 5-year survival rates can still reach 5882%, 3529%, and 1764%, respectively. Conclusions The preoperative hepatocellular carcinoma with normal hepatic function, the clear boundary between tumor and liver tissue should strive for surgical resection. Supplementation with other treatments after surgery can further improve the efficacy.