Introduction : Anatomical liver resection is the treatment of choice for hepatocellular carcinoma (HCC). Anterior approach with liver hanging technique is useful to prevent the dissemmination of tumor cells to systemic circulation. Thus, we aim to evaluate the short term results of anterior approach with liver hanging maneuver for anatomical resection.

Methods : A retrospective review of all patients with HCC who underwent anatomical resection from July 1 to December 20, 2019. The procedures were performed by 4 liver surgeons.

Results : Among 9 patients, there were 5 men and 4 women. The mean age was 53.3 ±11.5 years. The right hepatectomy was performed in 5 patients, the right anterior sectionectomy in 2 patients, and ventral segment preserving right hepatectomy in 2 patients with small left lobe. Anterior approach with liver hanging maneuver was performed in all patients. The mean tumor size is 8.9 cm. Two patients had macrovascular invasion (right hepatic vein and right posterior portal vein). The mean operative time was 231.1 ± 37.2 minutes with a mean estimated blood loss of 303.3 ± 450.6 ml. Complications included 1 bilake (Clavien-Dindo grade II) and 1 acute portal vein thrombosis (grade IVa) were reported. The mean length of hospital staybil was 12.2 ± 8.4 days. There was no reported 30 days mortality.

Conclusions : The anterior approach with liver hanging technique can be apply for various kind of anatomical resection. This procedure is technically safe and feasible.