Extracorporeal hepatic resection for advanced liver cancer

Hepatic resection is the most curative treatment for the patient with hepatocellular carcinoma (HCC) which occurs in the non-cirrhotic liver. It is not common, but extracorporeal hepatic resection (EHR) is sometimes considered as the treatment of otherwise unresectable tumors due to the location, size, and vascular invasion of the tumor. In the EHR, the liver is completely removed and perfused with the preservation solution. Bloodless transection of hepatic parenchyma is done, and reimplanted in the patient. Preoperative assessment of the vascular anatomy and liver volume, advanced surgical technique of hepatic resection and transplantation, and experienced postoperative care are essential to the accomplishment of EHR. In this issue, we give an outline of the indication, procedures, and the problems of EHR.