Management strategies to minimize mortality in liver resection for hepatocellular carcinoma

The precise assessment of both tumor factor and the liver function is of a crucial value the surgical treatment with the greatest guarantee of hepatocellular carcinoma (HCC), as the balance between the operative procedure and the remnant liver function is the most important concern in patients with chronic liver disease. The mortality rate in liver resection has decreased significantly worldwide, according to various surgical criteria for liver resection. Among countries where HCC is prevalent Japan is a leading country in doing liver resection. The Japanese evidence-based guidelines for the surgical treatment for HCC were generated in 2005, and the third revised version is now available. A strict evaluation policy for surgical indications and management based on such evidence helps to minimize the mortality rate in these patients. Herein, we report a series of unique approaches to the perioperative management of liver resection based on the available evidence with the goal of achieving 'no mortality' in liver resection for HCC.