Immediate recurrence in the hepatic remnant is sometimes evidenced after curative resection for treatment of hepatocellular carcinoma. One possible cause of this early recurrence is the multiple dissemination of tumor cells via the portal vein in the remnant liver as a result of surgical manipulations. In an attempt to prevent such recurrences, we performed ultrasonically guided, intraoperative portal embolization with starch microspheres in eight patients with hepatocellular carcinomas. These starch microspheres lodge only temporarily in the microvasculature, and there are no adverse effects, such as a rise in portal pressure or postoperative liver dysfunction. To date, there is no recurrence in any patient.