**1. Introduction**

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third leading cause of cancer-related deaths. More than 80% of HCC cases are from the Asian and African continents, and more than 50% of cases are from mainland China. It is estimated that more than 50% of liver cancers worldwide are attributable to HBV, and up to 89% of HBV-

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related HCC cases are from developing countries [1]. Recently, increasing trends in HCC incidence have been reported from several western countries, including France, Australia, and the United States, mainly because of the rising incidence of HCV [2]. At least one million new cases of HCC occur annually, and mortality from this disease remains high despite treatment. It was reported that 10–20% of newly diagnosed HCCs are >10 cm in diameter, which is commonly defined as huge HCC. Patients with huge HCC who survive more than 5 years were rarely reported in the literature. Recently, it is reported that a 5-year survival rate is less than 3–5% if without treatment. The mean overall survival rates via treatments at 1 year, 3 years, and 5 years are 66.1%, 39.7%, and 32.5%, respectively, 93.5%, 70.1%, and 59.1% for early-stage patients [1, 3–5]. Several novel strategies have been developed for the therapy of HCC in recent years, and the outcomes have taken marked progress. However, recurrence and metastasis rates remain high. Up to now, surgery, including hepatectomy and liver transplantation, remains to be the main curative strategy for hepatocellular carcinoma.

The developing history of hepatic surgery is strongly involved in the history of bleeding control during hepatic resections. In the early 1900s, a small but significant step forward was made in liver surgery by J. Hogarth Pringle [6], who in 1908 described a method for digital compression of the hilar vessels to control hepatic bleeding from traumatic injuries. Since the middle of the last century, right trisectionectomy (previous trisegmentectomy) has been used for huge hepatic neoplasms covering right and left medial section (Figure 1). In 1975, Starzl [7] described and clearly defined in detail a safe technique of right trisectionectomy (Figure 2). Then he reported his experience on 30 cases of the operation in 1980, including malignant and benign hepatic lesion [8]. Rui [9] reported his experience of 33 cases of primary liver cancer patients undergoing right trisectionectomy.
