ObjectiveTo investigate the effect of the round ligament fissure approach in re-hepatectomy.MethodsA total of 40 patients with recurrence of hepatocellular carcinoma (HCC) who underwent re-hepatectomy in the Department of Hepatopancreatobiliary Surgery of Leshan People’s Hospital from June 2017 to August 2020 were collected and divided into two groups according to different surgical approaches: study group (transhepatic round ligament fissure approach) and control group (conventional surgical approach), 20 cases in each group. The perioperative general indicators, peripheral blood laboratory indicators, and complications of the two groups were compared.ResultsCompared with the control group, the operation time, postoperative drainage tube removal time, and postoperative hospital stay of study group were shortened, and intraoperative blood loss was reduced (P<0.05). Compared with preoperatively in the same group, postoperative TBIL and ALT levels of the two groups decreased, and HGF levels increased (P<0.05). There was no significant difference in the levels of TBIL, ALT, and HGF between the two groups before surgery (P>0.05); at 1 month after surgery, there was no significant difference in the levels of TBIL and ALT between the two groups (P>0.05), but the HGF level of the study group was higher than that of the control group at1 month after operation, the difference was statistically significant (P<0.05). The changes before and after operation of TBIL and ALT were similar between the two groups (P>0.05), but the rising value of HGF in the study group was higher than that of the control group (P<0.001). There was no death in the two groups during the perioperative period, and the total postoperative complications were not statistically different (P=0.677). There was no statistically significant difference in the postoperative follow-up results between the two groups in recurrence, metastasis, and death (P>0.05).ConclusionRe-hepatectomy through the round ligament fissure approach can reduce the amount of intraoperative blood loss, shorten the operation time, and reduce the damage to the residual liver, which has high safety.