Abstract: Objective:To analyze the clinical efficacy and complications of hepatic resection in the treatment of primary hepatic carcinoma with portal hypertension.Methods:The clinical data of 489 patients with liver resection were retrospectively analyzed,including 68 patients with portal hypertension (13.91%), and the remaining 421 patients without combined portal hypertension (86.09%) were set as the control group.The postoperative complications,mortality,clinical baseline data,and survival rate of patients with two groups were evaluated by Cox regression model.Results:(1)Postoperative complications: observation group 20.59% and control group 13.54% (P<0.05).Two groups of patients with disease mortality comparison:after 30d (P>0.05);90d (P<0.05);(2)There was no significant difference in gender,age,tumor size,tumor size,tumor histology,cutting edge,and total bilirubin (P>0.05),total bilirubin level,tumor size,B Child-Pugh level and serum albumin level in two groups. The difference was statistically significant (P<0.05).The number and diameter of tumor were found to be independent risk factors (P<0.05) after hepatectomy for patients with cirrhosis by Cox regression model;(3)The survival rates of the control group 1st,2nd,5th,6th years were 91.1%,79.2%,56.21%,41%,respectively,while the observation group was 84.9%,69.3%,48.2%,22.3%,and the two groups were statistically different (P<0.05).Conclusion:Portal hypertension is not the primary hepatocellular carcinoma radical resection of absolute contraindications, small lesions in primary hepatocellular carcinoma with portal hypertension patients can choose corresponding hepatic resection.