To evaluate the safety and efficacy of reduced right hepatectomy with reserved right hepatic artery in the treatment of hepatocellular carcinoma (HCC) complicated with liver cirrhosis.

Clinical data of 8 HCC patients complicated with liver cirrhosis who underwent reduced right hepatectomy with reserved right hepatic artery in Hainan General Hospital from July 2018 to April 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 7 patients were male and 1 female, aged (51±8) years on average. The volumes of total liver and residual liver before surgery were measured by 3D reconstruction software. The right branch of the portal vein was separated and ligated. The right hepatic artery was reserved. The right liver was resected 1 cm rightwards from the ischemic line of left and right lobe, and liver tissues were partially preserved. The perioperative conditions of patients were observed.

Preoperatively, 3D reconstruction software was employed to simulate the right hepatectomy. The standard liver volume was (993±64) ml. The residual liver volume after standard right hepatectomy was (348±32) ml, accounting for (35.0±2.3)% of the standard liver volume. The residual liver volume was (428±34) ml after the resection plane was shifted 1 cm to the right side, accounting for (42.7±1.4)% of the standard liver volume. The right hepatectomy with reserved right hepatic artery were successfully completed in all the patients. No intraoperative complications occurred. The preserved liver tissues were found with normal redness. The operation time was (224±43) min and intraoperative blood loss was (220±52) ml. After operation, the parameters related to liver function were increased transiently, and decreased subsequently, and basically restored to normal at postoperative 7 d. After operation, the amount of abdominal drainage was slight, and all the abdominal drainage catheters were removed within postoperative 6 d. No small-for-size syndrome or liver failure occurred.

Reduced right hepatectomy with reserved right hepatic artery is a safe and efficacious surgery, which probably serves as a novel surgical option for HCC patients complicated with liver cirrhosis. It can preserve more liver tissues and prevent postoperative liver failure.