Objective：To investigate the safety of extended hepatic lobectomy for huge primary hepatic carcinoma (HPLC).
Methods：A retrospective analysis was made on the clinical data of 69 patients with HPLC who underwent extended lobectomy in our hospital within the recent 7 years. The data included preoperative liver functional reserve, liver resection volume, remnant liver volume and postoperative recovery and survival.
Results： Preoperatively,  ICGR15 was≤15% in all the patients, and the  estimated anatomic liver resection volume was 50% to 70%. Forty-three patients received radical liver resection and 26 palliative resection. Three patients died within 1 month after operation; the operative death rate was 4.3%. Postoperative complications occurred in 27.5% of the patients, but all recovered after treatment.
Conclusions：Assessment of hepatic functional reserve combined with accurate computer-aided measurements of liver volume can provide a reliable basis to determine the safe resected volume and proper limit of liver resection.