Skip to main content
Erschienen in:

14.06.2018 | original article

Efficacy of laparoscopic hepatectomy in patients with liver cirrhosis

verfasst von: Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Michio Okabe, Kazuyuki Kawamoto

Erschienen in: European Surgery | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Summary

Background

Hepatectomy in patients with liver cirrhosis is associated with a higher rate of complications. The purpose of this study was to evaluate the efficacy of laparoscopic hepatectomy in cirrhotic patients.

Methods

We introduced laparoscopic hepatectomy in our institution in April 2014. We performed 53 procedures on patients with cirrhosis from April 2014 to May 2017. Open hepatectomy was performed on 68 patients with cirrhosis from January 2010 to May 2017. This study retrospectively analyzed and compared the patient characteristics, perioperative factors, and short-term outcomes in the two groups.

Results

There were no conversions to open surgery in the laparoscopic hepatectomy group. With respect to patient characteristics, this group had significantly higher body mass index (p < 0.001), more patients with a past history of abdominal surgery (p < 0.021), and more patients with a past history of transarterial chemoembolization or radiofrequency ablation (p = 0.006). Regarding the short-term outcomes, the operation times were comparable (p = 0.709). The laparoscopic hepatectomy group had less blood loss (median 5 ml vs. 449.5 ml; p < 0.001), lower rate of intraoperative transfusions (1.9% vs. 22.1%; p = 0.001), and shorter postoperative hospital stays (median 7 days vs. 10 days; p < 0.001). The other results, including severe postoperative complications and mortality, were comparable.

Conclusion

Laparoscopic hepatectomy is a useful and viable option in patients with cirrhosis.
Literatur
1.
Zurück zum Zitat Farges O, Malassagne B, Flejou JF, Balzan S, Sauvanet A, Belghiti J. Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal. Ann Surg. 1999;229(2):210–5.CrossRefPubMedPubMedCentral Farges O, Malassagne B, Flejou JF, Balzan S, Sauvanet A, Belghiti J. Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal. Ann Surg. 1999;229(2):210–5.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Buell JF, Thomas MT, Rudich S, Marvin M, Nagubandi R, Ravindra KV, et al. Experience with more than 500 minimally invasive hepatic procedures. Ann Surg. 2008;248(3):475–86.PubMed Buell JF, Thomas MT, Rudich S, Marvin M, Nagubandi R, Ravindra KV, et al. Experience with more than 500 minimally invasive hepatic procedures. Ann Surg. 2008;248(3):475–86.PubMed
3.
Zurück zum Zitat Kaneko H, Takagi S, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T, et al. Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg. 2005;189(2):190–4.CrossRefPubMed Kaneko H, Takagi S, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T, et al. Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg. 2005;189(2):190–4.CrossRefPubMed
4.
Zurück zum Zitat Kazaryan AM, Pavlik Marangos I, Rosseland AR, Rosok BI, Mala T, Villanger O, et al. Laparoscopic liver resection for malignant and benign lesions: ten-year Norwegian single-center experience. Arch Surg. 2010;145(1):34–40.CrossRefPubMed Kazaryan AM, Pavlik Marangos I, Rosseland AR, Rosok BI, Mala T, Villanger O, et al. Laparoscopic liver resection for malignant and benign lesions: ten-year Norwegian single-center experience. Arch Surg. 2010;145(1):34–40.CrossRefPubMed
5.
Zurück zum Zitat Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009;250(5):831–41.CrossRefPubMed Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009;250(5):831–41.CrossRefPubMed
6.
Zurück zum Zitat Sasaki A, Nitta H, Otsuka K, Takahara T, Nishizuka S, Wakabayashi G. Ten-year experience of totally laparoscopic liver resection in a single institution. Br J Surg. 2009;96(3):274–9.CrossRefPubMed Sasaki A, Nitta H, Otsuka K, Takahara T, Nishizuka S, Wakabayashi G. Ten-year experience of totally laparoscopic liver resection in a single institution. Br J Surg. 2009;96(3):274–9.CrossRefPubMed
7.
Zurück zum Zitat Makuuchi M, Kosuge T, Takayama T, Yamazaki S, Kakazu T, Miyagawa S, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9(4):298–304.CrossRefPubMed Makuuchi M, Kosuge T, Takayama T, Yamazaki S, Kakazu T, Miyagawa S, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9(4):298–304.CrossRefPubMed
8.
Zurück zum Zitat Ichida F, Tsuji T, Omata M, Ichida T, Inoue K, Kamimura T, et al. New inuyama classification; new criteria for histological assessment of chronic hepatitis. Int Hepatol Commun. 1996;6(2):112–9.CrossRef Ichida F, Tsuji T, Omata M, Ichida T, Inoue K, Kamimura T, et al. New inuyama classification; new criteria for histological assessment of chronic hepatitis. Int Hepatol Commun. 1996;6(2):112–9.CrossRef
9.
Zurück zum Zitat Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24(2):289–93.CrossRefPubMed Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24(2):289–93.CrossRefPubMed
10.
Zurück zum Zitat Kanazawa A, Tsukamoto T, Shimizu S, Kodai S, Yamazoe S, Yamamoto S, et al. Impact of laparoscopic liver resection for hepatocellular carcinoma with F4-liver cirrhosis. Surg Endosc. 2013;27(7):2592–7.CrossRefPubMed Kanazawa A, Tsukamoto T, Shimizu S, Kodai S, Yamazoe S, Yamamoto S, et al. Impact of laparoscopic liver resection for hepatocellular carcinoma with F4-liver cirrhosis. Surg Endosc. 2013;27(7):2592–7.CrossRefPubMed
11.
Zurück zum Zitat Yamashita Y, Ikeda T, Kurihara T, Yoshida Y, Takeishi K, Itoh S, et al. Long-term favorable surgical results of laparoscopic hepatic resection for hepatocellular carcinoma in patients with cirrhosis: a single-center experience over a 10-year period. J Am Coll Surg. 2014;219(6):1117–23.CrossRefPubMed Yamashita Y, Ikeda T, Kurihara T, Yoshida Y, Takeishi K, Itoh S, et al. Long-term favorable surgical results of laparoscopic hepatic resection for hepatocellular carcinoma in patients with cirrhosis: a single-center experience over a 10-year period. J Am Coll Surg. 2014;219(6):1117–23.CrossRefPubMed
12.
Zurück zum Zitat Cheung TT, Dai WC, Tsang SH, Chan AC, Chok KS, Chan SC, et al. Pure laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 110 patients with liver cirrhosis: a propensity analysis at a single center. Ann Surg. 2016;264(4):612–20.CrossRefPubMed Cheung TT, Dai WC, Tsang SH, Chan AC, Chok KS, Chan SC, et al. Pure laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 110 patients with liver cirrhosis: a propensity analysis at a single center. Ann Surg. 2016;264(4):612–20.CrossRefPubMed
13.
Zurück zum Zitat Belli G, Limongelli P, Fantini C, D’Agostino A, Cioffi L, Belli A, et al. Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis. Br J Surg. 2009;96(9):1041–8.CrossRefPubMed Belli G, Limongelli P, Fantini C, D’Agostino A, Cioffi L, Belli A, et al. Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis. Br J Surg. 2009;96(9):1041–8.CrossRefPubMed
14.
Zurück zum Zitat Memeo R, de’Angelis N, Compagnon P, Salloum C, Cherqui D, Laurent A, et al. Laparoscopic vs. open liver resection for hepatocellular carcinoma of cirrhotic liver: a case-control study. World J Surg. 2014;38(11):2919–26.CrossRefPubMed Memeo R, de’Angelis N, Compagnon P, Salloum C, Cherqui D, Laurent A, et al. Laparoscopic vs. open liver resection for hepatocellular carcinoma of cirrhotic liver: a case-control study. World J Surg. 2014;38(11):2919–26.CrossRefPubMed
15.
Zurück zum Zitat Yoon YI, Kim KH, Kang SH, Kim WJ, Shin MH, Lee SK, et al. Pure laparoscopic versus open right hepatectomy for hcarcinoma in patients with cirrhosis: a propensity score matched analysis. Ann Surg. 2017;265(5):856–63.CrossRefPubMed Yoon YI, Kim KH, Kang SH, Kim WJ, Shin MH, Lee SK, et al. Pure laparoscopic versus open right hepatectomy for hcarcinoma in patients with cirrhosis: a propensity score matched analysis. Ann Surg. 2017;265(5):856–63.CrossRefPubMed
16.
Zurück zum Zitat Komorizono Y, Oketani M, Sako K, Yamasaki N, Shibatou T, Maeda M, et al. Risk factors for local recurrence of small hepatocellular carcinoma tumors after a single session, single application of percutaneous radiofrequency ablation. Cancer. 2003;97(5):1253–62.CrossRefPubMed Komorizono Y, Oketani M, Sako K, Yamasaki N, Shibatou T, Maeda M, et al. Risk factors for local recurrence of small hepatocellular carcinoma tumors after a single session, single application of percutaneous radiofrequency ablation. Cancer. 2003;97(5):1253–62.CrossRefPubMed
17.
Zurück zum Zitat Barcelona Liver Cancer Group, Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359(9319):1734–9.CrossRef Barcelona Liver Cancer Group, Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359(9319):1734–9.CrossRef
Metadaten
Titel
Efficacy of laparoscopic hepatectomy in patients with liver cirrhosis
verfasst von
Yusuke Ome
Kazuki Hashida
Mitsuru Yokota
Yoshio Nagahisa
Michio Okabe
Kazuyuki Kawamoto
Publikationsdatum
14.06.2018
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2018
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-018-0544-y

Weitere Artikel der Ausgabe 5/2018

European Surgery 5/2018 Zur Ausgabe