目的　探讨累及第 2肝门区巨大肝癌切除的可能性及手术方法。方法　 5 5例累及第2肝门区的巨大肝癌 ,平均癌灶直径 12 7cm(8～ 2 8cm) ,经右侧肋缘下或“屋顶式”切口进腹 ,充分暴露游离癌灶后在间歇性第 1肝门阻断下切除癌灶 ,切肝前预置腔静脉阻断带。结果　全组 5 5例无手术死亡。存活时间最长的 1例已达 4年无复发 ,术后 1、2、3、4年生存率分别为 6 3 %、5 0 %、5 0 %和30 %。结论　对单发肝脏巨大癌灶 ,不伴有肝硬化或肝硬化程度较轻的中青年患者 ,如癌组织生长缓慢 ,又无肝外转移时 ,虽影像学检查视为难以切除 ,但仍应争取开腹探查。 Objective To investigate the possibility of excision of hepatocellular carcinoma in the second porta hepatis and its surgical methods. Methods A total of 55 cases of hepatocellular carcinoma involving the second hepatic portal area with an average lesion diameter of 12 7 cm (8 to 28 cm) were performed under the right costal margin or “roof type” incision into the abdomen. The first hepatic hilar obstruction cuts off the foci, and the precancerous vena cava is pre-implanted. Results No deaths occurred in 55 patients in the whole group. The longest survival time was 4 years without recurrence. The 1, 2, 3, and 4 year survival rates were 63%, 50%, 50%, and 30%, respectively. Conclusions For single liver large tumors, young patients with moderate cirrhosis or less severe cirrhosis, if the cancerous tissue grows slowly and there is no extrahepatic metastasis, although imaging examination is considered difficult to remove, it should be Fight for laparotomy.