Anatomic liver resection is for irregular or localized liver resection. 1957 Couinaud proposed functional liver segmentation criteria, which divided the liver into 8 functional segments, and the results of both vascular perfusion and bile duct perfusion studies from the liver showed that the distribution of blood vessels or bile ducts in the liver followed a certain segmental pattern. Segments are the smallest functional units of the organ feasible for resection. In China, the vast majority of primary hepatocellular carcinomas occur in the context of hepatitis B cirrhosis, and intrahepatic metastases are disseminated through portal vein hematogenous metastases. Therefore regular resection of the area involved in the portal vein and its branches that supply blood flow to the part of the liver where the tumor is located should be a reasonable approach. Advantages of anatomical hepatectomy 1. Less bleeding Anatomical hepatectomy is based on regional blockage of blood flow to the liver segment where the tumor is located, and at the same time, through the non-vascular interface, few vascular biliary collateral branches need to be severed, so intraoperative bleeding is less than non-regular hepatectomy. 2.Little damage to liver function When dissecting the liver parenchyma, anatomical hepatectomy will not destroy the large blood vessels and bile ducts, so as to preserve the complete blood supply of the healthy liver tissue, avoiding ischemia and necrosis of the liver after surgery and reducing the possibility of liver failure after surgery. 3. High tumor-free survival Anatomical hepatectomy is based on liver segment as the basic resection unit, thus not only can the tumor be removed to the maximum extent, but also enough liver tissue can be preserved. At the same time, because the blood supply of the liver segment where the tumor is located is ligated in advance, intraoperative operation will not cause tumor dissemination due to squeezing the tumor. Technical difficulties of anatomical hepatectomy Anatomical hepatectomy requires a thorough understanding of the anatomy of the liver and familiarity with the course of the blood vessels and bile ducts in each segment of the liver. One can skillfully dissect the first and second hepatic hilum, while applying ultrasound localization. Combined with CT and MRI where the tumor is located, regional block is taken to precisely remove the tumor. Limitations of anatomical hepatectomy Anatomical hepatectomy is not suitable for cases with severe cirrhosis, poor liver function reserve capacity, or small hepatocellular carcinoma at the edge of the liver. Current status of anatomical liver resection in our department We have been to Japan, USA, UK and other developed countries for many times for liver resection study and exchange. In particular, we have studied at the Makuuchi Yami Center in Japan and have fully mastered the systematic anatomy of the liver and anatomical liver resection, completing about 250 cases of liver surgery each year. In the last three years, we have performed anatomical liver resection on more than 300 patients, and the patients have less intraoperative bleeding, low incidence of postoperative liver failure, and fast recovery of liver function. The five-year tumor-free survival is significantly higher than that of irregular hepatectomy in the same period. Moreover, the overall patient cost is significantly lower, with most patients’ hospitalization cost around 20,000, which greatly saves medical costs. Benefit the local people.