Hepatocellular carcinoma (mainly hepatocellular carcinoma) is a major malignant tumor with a high incidence in the southeast coast of China. Recent epidemiological surveys show that there are about 626,000 new cases of hepatocellular carcinoma worldwide each year, of which China accounts for about 45% of the new cases. The number of hepatocellular carcinoma deaths worldwide is about 250,000 each year, and the number of cases in China is 130,000, accounting for about 53% of the deaths from hepatocellular carcinoma worldwide. The anatomical study of the liver in the 1950s laid the foundation for the development and progress of hepatocellular carcinoma surgery, and the resection of large hepatocellular carcinoma by Lort-Jacob in 1952 marked the first leap in the treatment of hepatocellular carcinoma. In the 1970s, the local resection of small hepatocellular carcinoma greatly improved the surgical efficacy of liver cancer, and the establishment and widespread use of AFP test in the same period greatly improved the diagnosis of early hepatocellular carcinoma, which significantly improved the overall 5-year survival rate of liver cancer. Especially, the development of imaging technology, the application of new surgical instruments, the maturity of liver transplantation technology (especially living liver transplantation technology), the development of lumpectomy surgery and the change of liver cancer surgery concept have made great progress in the surgical treatment technology of liver cancer. Therefore, early diagnosis of small hepatocellular carcinoma, especially small hepatocellular carcinoma, is crucial to improve the surgical resection rate and prolong the postoperative survival rate of hepatocellular carcinoma. The diagnosis includes serological diagnosis, imaging diagnosis and pathological histological diagnosis. Alpha-fetoprotein (AFP) is still the most specific marker for the diagnosis of PLC, and its role in diagnosis, judging the efficacy, estimating prognosis and predicting recurrence is relatively certain. In recent years, with the development of immunohistochemistry and proteomics, many effective biomarkers have been discovered, such as abnormal prothrombin (DCP), Golgi protein 73 (GP73) and alpha-fetoprotein heteroplasm 3 (AFP-L3), which are promising tumor markers for clinical application and can effectively reduce the missed detection rate of AFP-negative hepatocellular carcinoma patients. In particular, DPC has a good complementary effect on the diagnosis of hepatocellular carcinoma. The advent of CT has made a qualitative leap in the imaging diagnosis of hepatocellular carcinoma and led to the progress of hepatobiliary surgery, and now CTA and CTAP are considered to be the most accurate techniques for preoperative detection and number determination of malignant lesions in the liver. PET-CT can reflect both pathophysiological changes and morphological structure of the lesions, which significantly improves the accuracy of diagnosis. We can diagnose liver cancer early and differentially, identify recurrence of liver cancer, stage and restage liver cancer, find the primary foci and metastases, guide and determine the treatment plan and evaluate the efficacy of liver cancer. Among liver cancer patients, a considerable number of patients have changed their treatment plan after PET-CT examination due to a clear diagnosis; PET-CT can accurately evaluate the efficacy of treatment, timely adjust the treatment plan, avoid ineffective treatment, save medical costs for patients, and gain valuable treatment time. Angiography is currently a common method for preoperative evaluation of hepatocellular carcinoma diagnosis and interventional treatment, and is the gold standard for judging the morphology of liver vessels. Foreign scholars have concluded that DSA is significantly better than CTA in detecting hepatocellular carcinoma lesions <2mm in diameter. Considering the invasiveness and cost of DSA, it is gradually replaced by spiral CT and PET-CT as an examination method in clinical practice. Many clinical center studies have proved that liver failure is the main cause of intraoperative and even postoperative death in hepatocellular carcinoma, and good liver reserve function is the basis for treatment of hepatocellular carcinoma, and proper assessment of liver reserve function is crucial for selecting treatment modality, improving survival rate and reducing postoperative complications in hepatocellular carcinoma patients. ICG excretion test is the most widely used method to measure liver excretion function in China, Japan and other Asian countries. It is a commonly used method to assess liver reserve function and has been gradually accepted by European and American countries in recent years. Hepatobiliary surgeons pay more attention to the evaluation of reserve function of the reserved liver before performing liver resection. The physical volume (or the corresponding ratio) of the reserved liver is an important indicator when evaluating the reserve function of the reserved liver. It was found that when the ratio of reserved liver volume to functional liver parenchyma volume was less than 30%, post-hepatectomy complications were significantly increased and the time in the ICU was significantly longer. Medical imaging techniques can calculate the volume size of the overall liver, pre-resected liver and remnant liver in patients undergoing hepatectomy, and calculate the volume of the pre-resected liver and the volume of the remnant liver as a percentage of the overall liver volume to assess the surgical risk in conjunction with the actual liver function of the patient. Using 3D surgical simulation software, the entire hepatotomy procedure can be simulated and both the resected liver volume and the residual liver volume can be calculated, and there is a statistical correlation between its simulated hepatotomy volume and the actual resection results. Therefore, the development of modern medical imaging technology also plays a great role in promoting the progress of liver cancer surgical treatment technology. As liver cancer is multicentric in nature, liver transplantation can remove all the tumors, cirrhosis and other liver lesions, change the environment of tumor growth, and provide the possibility of radical resection of multifocal and multilobar tumors. At the same time, liver transplantation can completely cure cirrhosis, avoid liver failure after liver resection caused by insufficient liver reserve function, and effectively solve portal hypertension and complications of cirrhosis. However, liver transplantation has the disadvantages of lack of liver sources, difficulty in avoiding graft rejection, easy occurrence of postoperative bile duct and bile duct infection complications, the need for lifelong immunosuppressive drugs, and expensive treatment costs. The selection criteria for liver transplantation in patients with hepatocellular carcinoma are controversial, including the Milan, Pittsburgh, California, Shanghai Fudan and Hangzhou standards in China. Minimally invasive surgery In 1991, Reich et al. first reported two cases of laparoscopic hepatectomy (LH), and the LH technique has been progressing with the development of laparoscopic surgical instruments and the accumulation of operator experience. With the improvement of laparoscopic instruments and the improvement of the surgeon's operating skills and experience, the scope of this indication has been expanded and laparoscopic techniques have become involved in all areas of liver surgery. The introduction of da Vinci robotic surgery system has created a new technology for minimally invasive surgical treatment of hepatocellular carcinoma, solving the limitations of traditional laparoscopy in terms of field of vision and flexibility of operating instruments, which are very difficult to reconstruct bile ducts and blood vessels under laparoscopy. There is no significant difference between the two groups. Laparoscopic surgery is safe and feasible and shows great advantages over open surgery, reflecting the concept of "eliminating the tumor while maximizing the preservation of the body". Because of the high selectivity of laparoscopic hepatocellular carcinoma resection cases and the lack of multicenter, large-sample prospective randomized controlled studies, there is a lack of high-level evidence-based medical evidence on the prognosis of oncology, especially long-term survival, compared with open surgery. It is generally accepted that attention to tumor-free operation techniques, reduction of pneumoperitoneal pressure, and application of specimen bags can effectively reduce the chance of tumor implantation and metastasis. Although laparoscopic surgery has shown advantages and has been greatly developed, it is still in the exploration stage. With the continuous accumulation of surgical experience, maturity of technology, continuous improvement of instruments and continuous improvement of lumpectomy ultrasound navigation system, laparoscopic treatment of HCC will have a broad application prospect. Progress in prevention and treatment of recurrence of hepatocellular carcinoma after surgery Recurrence of hepatocellular carcinoma after liver resection has become an important factor seriously affecting patients' prognosis. About 70% of patients will have recurrence 5 years after liver resection, and the recurrence rate of early hepatocellular carcinoma 5 years after surgery is over 40%. Recurrence after liver cancer resection has become a major factor of death, and the focus of attention after liver cancer surgery is naturally on the prediction, prevention and treatment of tumor recurrence, and there are many basic researches at home and abroad. In order to screen high-grade patients with recurrence after hepatocellular carcinoma surgery, several individualized prediction methods and individualized clinicopathological score prediction models have been established. Any treatment measure for hepatocellular carcinoma can be applied to the treatment of recurrence of hepatocellular carcinoma Among these methods re-surgical resection is an important means to obtain radical treatment for recurrence of primary hepatocellular carcinoma after surgery, which can achieve better long-term survival than other palliative measures. Both Japanese and Italian studies have confirmed that liver resection (including liver transplantation) is the most effective for intrahepatic recurrence of hepatocellular carcinoma, with remedial liver transplantation (salvage liver transplantation) being an effective strategy in the treatment of hepatocellular carcinoma as an effective method to control tumor load and alleviate the shortage of donor liver sources. The long-term survival rate of primary hepatocellular carcinoma recurrence reoperation after surgery is comparable to that after the first hepatectomy. The interval between the first resection and postoperative recurrence of hepatocellular carcinoma is directly proportional to the prognosis, the longer the interval, the better the prognosis. If reoperation is not possible, patients can choose targeted therapy, biologic therapy, immunotherapy, TACE and minimally invasive treatments such as radiofrequency, microwave and freezing, as well as traditional Chinese medicine according to their specific conditions. In summary, with the advancement of surgical technology and the updating of treatment concept, there is no absolute contraindication for surgical resection of hepatocellular carcinoma in recent years, and more and more hepatocellular carcinoma patients have been able to undergo surgical resection and obtain the chance of radical treatment. At present, the comprehensive treatment model of liver cancer mainly based on surgery has been established as an important means of clinical treatment for liver cancer. In the future, the research direction of liver cancer treatment still focuses on early prevention, early diagnosis and early treatment, and with the gradual formation of an extra-individual and planned multidisciplinary comprehensive treatment model mainly based on surgical treatment, the overall treatment effect of liver cancer will be further improved.