To investigate the clinical efficacy and safety of mesohepatectomy with Glissonean pedicle transection in the treatment of hepatocellular carcinoma (HCC) complicated with liver cirrhosis.

Clinical data of 20 patients with HCC complicated with liver cirrhosis who underwent mesohepatectomy with Glissonean pedicle transection in the First People's Hospital of Foshan from June 2014 to March 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among 20 patients, 15 cases were male and 5 female, aged 31-64 years with a median age of 48 years. 18 patients was classified with liver function Child-Pugh grade A and 2 were Child-Pugh grade B. The median indocyanine green (ICG) retention rate at 15 minutes was 0.058 (0.034-0.099) and the tumor diameter was 6.6 (3.0-13.0) cm.

Mesohepatectomy with Glissonean pedicle transection was successfully performed in all patients. The length of porta hepatis occlusion was 23 (15-30) min, and the right lobe was 67 (60-80) min. The operation time was 390 (300-480) min, the intraoperative blood loss was 590 (200-1 500) ml and the intraoperative blood transfusion rate was 20% (4/20). After operation, bile leakage occurred in 2 cases, and they were cured after percutaneous drainage. No perioperative death was observed. The follow-up time was 156 to 240 months. 3 cases suffered tumor recurrence during the follow-up period.

Mesohepatectomy with Glissonean pedicle transection is safe and effective. Precise anatomical hepatectomy can be achieved by choosing suitable patients, having proficient skill in Glissonean pedicle transection and precisely defining cutting surface, especially for patients with HCC complicated with liver cirrhosis.