To investigate the prevention and treatment of hemorrhage after hepatectomy for patients with hepatocellular carcinoma (HCC).

Clinical data of 10 HCC patients with hemorrhage after hepatectomy in the First People's Hospital of Foshan between December 2010 and December 2016 were retrospectively analyzed. Among them, 8 cases were males and 2 were females, aged 42-68 years old with a median age of 48 years old. Laparoscopic resection of patial segment of the middle lobe was performed on 5 cases, open right hemihepatectomy on 2, laparoscopic resection of segments Ⅴ, Ⅷ and patial segments Ⅳ on 1, and laparoscopic left hemihepatectomy on 2. The informed consents of all patients were obtained and the local ethical committee approval was received. The causes and treatment of postoperative hemorrhage were analyzed.

Hemorrhage within postoperative 48 h was observed in 9 cases, including 5 cases with the liver wound surface hemorrhage, 1 with short hepatic vein hemorrhage, 1 with right hepatic vein hemorrhage, 1 with hepatic vein hemorrhage and 1 with gallbladder artery hemorrhage. The hemorrhagic spots were all found after exploratory surgery and were definitely sutured for hemostasis. One case suddenly suffered from hemorrhage over 10 d after surgery. The patients could not undergo embolization due to hemorrhage at the root of right gastric artery, thus surgical exploration was performed and the hemorrhagic spots at the common hepatic artery and bile leakage on the liver wound surface were repaired. No rebleeding or other complications were observed during 2 months follow-up.

Prevention is the emphasis for hemorrhage after hepatectomy for HCC. Strict preoperative evaluation, precise and standard intraoperative operation, intimate postoperative observation and timely surgical intervention can decrease postoperative mortality.