To investigate the surgical individualized treatment for Primary liver cancer(PLC) with portal hypertension and hypersplenism.

One hundred and five PLC cases with portal hypertension and hypersplenism admitted in the hepatobiliary department of first affiliated hospital of SYSU at recent decade between January 2002 and December 2011 were studied respectively, fifty-seven cases received synchronous hepatectomy and splenectomy(combined group), 44 cases for hepatectomy only(hepatectomy group), 4 cases for hepatectomy and spleen artery ligation.

The platelet and white blood cell counts in combined group recovered to normal in 1-2 weeks. Average blood loss(ml) in combined group versus hepatectomy group were 903.62±139.24 vs 802.56±146.52, t = 3.535, P < 0.01.Complication incidence cases were 14 vs15 respectively, χ² =1.102, P > 0.05. Each groups had two deaths during the peri-operative period.

Synchronous hepatectomy and splenectomy should be consider a choice of operation for PLC accompanied portal hypertension and hypersplenism. It may be safe with indication properly chosen and well treatment during the peri-operative period. The critical point is to establish the surgical individualized treatment for reducing the complication rate and mortality, so as to improve the effective treatments.