He Moumou, female, 49 years old, was admitted to the hospital with “hepatic occupational lesion found 1 week ago”. The patient was found to have a hepatic occupational lesion 1 week ago, and complained of distension and pain under the glabella after a full stomach, no dizziness or headache, no chest tightness, shortness of breath or chest pain, no lumbago, no nausea or vomiting. On June 25, 2013, he went to the local hospital and underwent ultrasound examination of the abdomen and urinary system, which showed that the left inner and outer lobes of the liver were substantially occupied, the nature of which was to be determined, and the left kidney was a cystic lesion. A subsequent CT examination of the upper abdomen showed that the left lobe of the liver was altered, suggesting primary hepatocellular carcinoma, and a small cyst in the left kidney. The patient was admitted to our hospital for further diagnosis and treatment. The patient had lost weight since the beginning of the disease and had no other abnormalities. He was in good health. Physical examination: body temperature 36.7℃, pulse 85 times/min, respiration 20 times/min, blood pressure 131/75mmHg, specialist examination: abdominal wall is flat, no scar, no muscle tension, a mass of about 4m*5cm in size can be palpated under the saber, smooth surface, moderate mobility, no fluctuating sensation, percussion pain in the liver area, no pressure pain, no rebound pain, liver and spleen are not reached under the ribs, no mobile turbid sounds, intestinal The intestinal tones were normal. Auxiliary examinations: 1. Ultrasound examination of the abdomen and urinary system showed: substantial occupancy of the left inner and outer lobe of the liver, nature to be determined, and cystic lesion of the left kidney. 2. CT examination of the upper abdomen showed: alteration of the left lobe of the liver, proposed primary hepatocellular carcinoma, and small cyst of the left kidney. Huang Gang, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Guangzhou Medical University After admission, he decided to perform “laparoscopic left hemicolectomy” after thorough preoperative examination and preparation, in order to remove the tumor completely and reduce trauma. Intraoperatively, we saw a giant tumor in the left outer lobe of the liver with a diameter of about 7 cm, the surface was uneven and dark, and grayish-yellow lesions of different sizes were seen in between, and two lesions with a diameter of about 1.5*3 cm were seen at the junction of Siva and b in the left inner lobe, the smaller one was near the edge of the left half of the liver. The left and right hepatic ducts, common hepatic duct and common bile duct were not dilated. The gallbladder was normal in size and shape, without congestion and no thickening of the gallbladder wall. There were no nodules or hepatic sclerosis in the right liver. No abnormalities were seen in the remaining organs. Surgical procedure: 1, the patient was lying down with a pillow under the waist, and after endotracheal anesthesia, the skin was disinfected with anl iodine and sterile towels were laid. 2, the skin and subcutaneous were incised at the umbilical level, and a pneumoperitoneum needle was inserted, and after satisfactory inflation, a trocar was inserted and a laparoscope was put in. 3.Separate the gallbladder duct, supraclamp, retrograde resection of the gallbladder, preserving the gallbladder duct first. 4.Cut the perihepatic ligament, free the left lobe of the liver, dissect out the first hepatic hilar, dissect out the left hepatic artery, left branch of portal vein, ligate the left hepatic artery, left branch of portal vein and cut off, control the blood flow into the liver, the left half of the liver is seen to be ischemic changes, the electric knife marks the cut line. According to the anatomical markings of the liver, the liver parenchyma was severed on the pre-cutting line with ultrasonic knife, PK knife and other liver cutting instruments. When the intrahepatic ducts were larger than 2 mm in diameter, biological clamps were used to close them or cutting anastomoses were used to prevent bleeding and bile leakage. Complete resection of the mass. 5. U-shaped sutures on section 7. Hemostasis was satisfactory.6. A 10-cm-long incision was made in the right upper abdomen, and the left half of the severed liver was removed in sequence into the abdomen, and the abdominal cavity was repeatedly flushed with distilled water.7. A piece of hemostatic gauze was disposed of in the diaphragmatic trauma. A latex drainage tube was placed in the subdiaphragmatic space and drained out of the body from the abdominal wall by poking holes. The patient was returned to the ward after surgery and the specimen was sent for pathological examination. 1, primary hepatocellular carcinoma; 2, chronic cholecystitis; 3, left renal microcyst 1, (left hepatic tumor) intrahepatic cholangiocarcinoma (moderately differentiated), tumor infiltration of the hepatic peritoneum, with intrahepatic metastasis. Hepatocellular siltation and focal lymphocytic infiltration in the confluent area were seen in the surrounding liver tissue.