Open Minor Hepatectomy with Takasaki’s Glissonean Pedicle Control for Hepatocellular Carcinoma: A Vietnamese Cohort Study

Surgical resection remains a curative-intent treatment for hepatocellular carcinoma, but procedure-specific evidence for open minor hepatectomy using Takasaki’s Glissonean pedicle control remains limited. We retrospectively reviewed 74 consecutive patients with histologically confirmed hepatocellular carcinoma who underwent elective open minor hepatectomy, defined as resection of fewer than three Couinaud segments, using Takasaki-style Glissonean pedicle control at a Vietnamese hepatopancreatobiliary center between January 2021 and March 2024. Survival was estimated using the Kaplan–Meier method, and prognostic factors were explored using Cox regression. All patients had Child–Pugh class A liver function; 81.1% were hepatitis B surface antigen-positive and 87.8% had Barcelona Clinic Liver Cancer stage A disease. Median tumor diameter, operative time, and blood loss were 42 mm, 150 min, and 200 mL, respectively. R0 resection was achieved in 94.6%. Post-hepatectomy liver failure, major complications, and 90-day mortality occurred in 1.4%, 4.1%, and 1.4%, respectively. At a median follow-up of 39.6 months, 3-year overall and disease-free survival were 74.7% and 59.9%. This approach appears feasible and safe in selected Child–Pugh class A patients, with acceptable mid-term oncological outcomes.