Objective To report our experience of retrograde hepatectomy in 244 cases of difficultly resected liver cancer. Methods Large, poor-exposure and inferior vena cava (IVC)-involving liver cancers that were difficult to remove by classical hepatectomy, have been resected successfully by retrograde hepatectomy combined with vascular surgical techniques in 244 patients (group A). Thirty one patients with similar circumstances undergoing classical hepatectomy duing the same period served as controls (group B). Results There were no perioperative mortalities in both groups. The comparison between group A and group B, the estimated intraoperative blood loss was 1290±998 ml versus 2286±1363 ml, post-operative pleural effusions occurred in 26/244 versus 10/31, ascites in 72/244 versus 19/31, moderate to severe jaundice in 14/244 versus 5/31, effusion in the operative area in 17/244 versus 7/31, subphrenic infection in 3/244 versus 1/31, bile leakage in 2/244 versus 1/31, wound infection in 3/244 versus 1/31, respectively. The time until ALT normalizaton in the groups A and B was 13.8±5.1 days and 18.9±8.9 days respectively. The difference between the two groups were statistically significant (P<0.01). Conclusion Retrograde hepatectomy is a safe and effective method for difficultly resected liver cancer. Key words cancer - liver - liver surgery - retrograde
