Hepatectomy for large and giant hepatocellular carcinoma: a 20 years review

Abstract

Hepatocellular carcinoma (HCC) is the most common malignant cancer in China. The size of HCC can be categorized into 4 grades: (1) micro-HCC, the diameter of the HCC is ≤2 cm; (2) small HCC, the diameter of the HCC is between 2 and 5 cm; (3) large HCC, the diameter of the HCC is between 5 and 10 cm; (4) giant HCC, the diameter of the HCC is > 10 era. The new classification helps to choose the appropriate methods and to analyze the curative effect for various kinds of HCC respectively. The resection of large and giant HCC is safe and feasible. During the past 20 years, we have modified and innovated some techniques of HCC surgery, including hepatectomy without dissecting the hepatic hilus, increasing the safety time limit of portal pedicle occlusion from 15-20 minutes to 20-60 minutes, in situ bepatectomy with occlusion of hepatoduodenal ligament and infrahepatic vena cava, and double hanging maneuver techniques. The techniques mentioned above improved the bleeding control of hepatectomy, and enhanced the long-term survival rate of HCC patients. Key words: Liver neoplasms; Hepatectomy