关键词: 肝细胞癌, 专家共识, 肝切除, 乙肝, 肝硬化, 安全性评估

Abstract: In China，more than 80% of patients with hepatocellular carcinoma (HCC) are associated with varying degrees of HBV-related liver cirrhosis.Different from the Western countries,hepatectomy remains as the one of the mainstay choices for HCC with liver cirrhosis.The severity of cirrhosis of HCC patients varies greatly from individual to individual. Although the patients’liver function is at the compensated stage.With the development of liver cirrhosis,both hepatic functional reserve and regenerative capacity are considerably diminished,the incidence of surgical complications and post-hepatectomy liver failure will increase correspondingly.Therefore,maximally preserving the amount of liver parenchyma is crucial to maintaining essential liver function for cirrhotic HCC patients.The insufficient understanding of the relationship between post-hepatectomy liver failure and the severity of liver cirrhosis for patients has led to a lack of agreement on selecting reasonable surgical modalities and preserving sufficient future liver remnant volume.This results in a scarcity of concrete guidance for clinically preventing and treating post-hepatectomy liver failure,substantially compromising the surgical efficacy in HCC patients.Minimizing the incidence of postoperative hepatic insufficiency and mortality rates in cirrhotic HCC patients deserve to be further studied.The Chinese Chapter of the International Hepato-Pancreato-Biliary Association and Hepatic Surgery Group of Surgical Branch of Chinese Medical Association invited well-known experts in liver surgery and hepatology in China,mainly elaborate the role of the severity of liver cirrhosis in the safety evaluation of hepatectomy, and how to improve surgical safety,which may assist liver surgeons to make appropriate surgical decisions for HCC patients with liver cirrhosis.

Key words: hepatocellular carcinoma；expert consensus, hepatectomy；HBV；liver cirrhosis；safety assessment