Recently, the Department of Hepatobiliary and Pancreatic Surgery of our hospital successfully performed a case of complex hepatocellular carcinoma resection with post-hepatic inferior vena cava artificial vessel replacement. This is also the first case of post-hepatic inferior vena cava replacement performed in our hospital, marking a new step forward in the level of medical diagnosis and treatment supported by years of clinical techniques accumulated in our hospital, such as precise liver dissection, liver resection, liver access route selection and liver transplantation. The patient was diagnosed with suspicious liver abscess in the local hospital due to weakness and fever for one month, and came to our hospital after treatment failed. After various detailed examinations in our hospital, primary liver cancer was considered. After discussion between Prof. Peng Zhihai and all physicians of hepatobiliary surgery, and communication with the patient’s family, it was decided to perform a caesarean section and adequate preoperative preparation. During the operation, it was found that the patient’s tumor was about 6 cm in diameter in size, mainly located in the caudal lobe and the right anterior lobe of the liver with unclear border and incomplete membrane, and invaded the right hepatic vein and part of the posterior inferior hepatic vena cava, which supported the preoperative diagnosis of primary liver cancer. In order to obtain a better prognosis for the patient, the surgical team with Chief of General Surgery Peng Zhihai as the main surgeon carefully freed the right half of the liver and caudate lobe containing the tumor along the vessels. After blocking the right hepatic vein and inferior hepatic vena cava, the posterior hepatic vena cava was removed together with the mass and the artificial vessel was replaced again. With the cooperation of Dr. Guohui Xu’s anesthesia team, the operation was successful after 4 hours of effort. Since the surgical approach did not affect the blood flow of the remaining left hepatic half, intraoperative bleeding was low and the patient recovered smoothly after surgery.