Objective:To investigate the prognostic factors that influence Barcelona (Barcelona clinical liver cancer staging system, BCLC)stage B hepatocellular carcinoma patients after hepatectomy.Methods:Retrospective analysis was made on clinical and pathological data of 50 standardized hemihepatectomy in Barcelona stage B hepatocellular carcinoma from 2013 to 2017.Results:Single-factor results showed that high expression of tumor microvascular invasion (MVI) and proliferation of nuclear antigen (Ki-67) were the prognostic factors ( respectively χ 2 =8.411, 10.939, all P<0.05). Multivariate analysis showed that the difference of high expression of Ki-67 and survival rate was statistically significant (respectively F=5.710, 8.254, all P<0.05). Ki-67 expression level and tumor differentiation were statistically significant (χ 2=0.497, P<0.05). There was a statistically significant difference in survival between the high-risk group and the low-risk group according to the risk factors (χ 2=12.152, P<0.05). Conclusions:MVI and high expression of Ki-67 were high risk factors affecting the overall survival rate of liver cancer after hemihepatectomy.

Objective To investigate the application value of precise hepatectomy following important liver vessels for hepatobiliary tumors. Methods Clinical data of 26 patients with hepatobiliary tumors in the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2013 were analyzed retrospectively. There were 14 males and 12 females with the age ranging from 20 to 66 years old and a median of 56 years old. The informed consents of all patients were obtained and local ethical committee approval had been received. The important vessels closely adjacenting to tumors were selected as the guide line for dissection according to the preoperative imaging examinations and intraoperative exploration results and the liver resecting surface was predicted. The anatomic relations between the tumor and the important liver vessels such as portal branch, hepatic vein, inferior vena cava were deifned by intraoperative ultrasound. Precise hepatectomy were performed with surgical instruments such as cavitron ultrasonic surgical aspirator, bipolar coagulator. Results The operations of 26 patients were performed successfully and the tumors were resected completely, including left hemihepatectomy+caudate lobectomy (n=7), right hemihepatectomy (n=6), mesohepatectomy (n=4), extended right hemihepatectomy (n=3), segmentⅣb, V hepatectomy (n=2), hepatic right anterior lobectomy (n=2), left hemihepatectomy + caudate lobectomy +pancreaticoduodenectomy (n=1), caudate lobectomy+artiifcial vessel replacement of retrohepatic inferior vena cava (n=1). The average operative time was (5.3±0.4) h, the intraoperative blood loss was (580±59) ml and the length of hospital stay was (19±3) d. No severe complications such as massive haemorrhage, liver failure were observed after operation. Abdominal infection was observed in 2 cases and biliary leakage in 1 case after operation and all were cured by anti-infection and drainage treatments. Conclusion Precise hepatectomy following the important liver vessels is a safe and effective surgical procedure for hepatobiliary tumors.