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Laparoscopic Liver Surgery for Patients with Hepatocellular Carcinoma

  • Hepatic and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Laparoscopic hepatectomy is feasible for hepatocellular carcinoma (HCC) today. This is a retrospective study of the patients with HCC treated by liver resection with a totally laparoscopic approach.

Methods

This study recruited 116 patients (92 male, 24 female) that underwent laparoscopic liver resection (LR) for HCC. Patients were divided into two groups: group I: (n = 97, 78 male,19 female) those with a volume of resection less than two segments; group II: (n = 19, 14 male, 5 female) those with a volume of resection of more than two segments. The distribution of the tumor-node–metastasis (TNM) stage of patients in the two groups was not significantly different.

Results

Patients resumed full diet on the second or third day after the operation, and the average length of hospital stay was 6 days. The operation time was 152.4 ± 336.3 min and 175.8 ± 57.4 min, while blood loss was 101.6 ± 324.4 mL and 329.2 ± 338.0 ml, for groups I and II, respectively. Five patients (5.2%) in group I and three patients (15.8%) in group II required blood transfusion (p = 0.122). The mortality rate was zero among our patients and complication rates were 6.2% and 5.2% for groups I and II, respectively. The 1-year, 3-year, and 5-year survival rates were 85.4%, 66.4%, and 59.4% for group I, and 94.7%, 74.2%, and 61.7% for group II, respectively, with no significant difference between two groups (p = 0.1237).

Conclusion

Laparoscopic liver resection is a procedure of significant risk and is more technically demanding in comparison with traditional open method. There was no significant difference in survival rates, based on the volume of resection. Laparoscopic surgery should be performed in selected patients as the postoperative quality of life of patients is better than that with open resection.

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References

  1. Samama G, Chiche L, Brefort JL, et al. Laparoscopic anatomical hepatic resection. Report of four left lobectomies for solid tumors. Surg Endosc 1998;12:76–8

    Article  PubMed  CAS  Google Scholar 

  2. Ker CG, Chen HW, Juan CC, et al. Laparoscopic Sub-segmentectomy for Hepatocellular Carcinoma with Cirrhosis. Hepatogastroenterology 2000;47:1260–3

    PubMed  CAS  Google Scholar 

  3. Chen HY, Ker CG, Juan C-C, et al. Laparoscopic left hepatectomy for liver tumor. Formosan J Surg 2002;35:246–52

    Google Scholar 

  4. Lo CM, Lai EC, Liu CL, et al. Laparoscopy and laparoscopic ultrasonography avoid exploratory laparotomy in patients with hepatocellular carcinoma. Ann Surg 1998;227:527–32

    Article  PubMed  CAS  Google Scholar 

  5. Lai EC, Lau WY. Spontaneous rupture of hepatocellular carcinoma: A systematic review. Arch Surg 2006;141:191–8

    Article  PubMed  Google Scholar 

  6. Santambrogio R, Opocher E, Ceretti AP, et al. Impact of intraoperative ultrasonography in laparoscopic liver surgery. Surg Endosc 2007;21:181–8

    Article  PubMed  CAS  Google Scholar 

  7. Descottes B, Lachachi F, Sodji M, et al. Early experience with laparoscopic approach for solid liver tumors: Initial 16 cases. Ann Surg 2000;232:641–5

    Article  PubMed  CAS  Google Scholar 

  8. Dulucq JL, Wintringer P, Stabilini C, et al. Isolated laparoscopic resection of the hepatic caudate lobe: Surgical technique and a report of 2 cases. Surg Laparosc Endosc Percutan Tech 2006;16:32–5

    Article  PubMed  Google Scholar 

  9. Nord HJ, Brady PG. Endoscopic diagnosis and therapy of hepatocellular carcinoma. Endoscopy 1993;25:126–30

    PubMed  CAS  Google Scholar 

  10. Kaneko H, Takagi S, Shiba T. Laparoscopic partial hepatectomy and left lateral segmentectomy: Technique and results of a clinical series. Surgery 1996;120:468–75

    Article  PubMed  CAS  Google Scholar 

  11. Azagra JS, Goergen M, Gilbart E, et al. Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc 1996;10:758–61

    Article  PubMed  CAS  Google Scholar 

  12. Chang S, Laurent A, Tayar C, et al. Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg 2007;94:58–63

    Article  PubMed  CAS  Google Scholar 

  13. Kameda Y, Asakawa H, Shimomura S, et al. Laparoscopic prediction of hepatocellular carcinoma in cirrhosis patients. J Gastroenterol Hepatol 1997;12:576–81

    PubMed  CAS  Google Scholar 

  14. Weitz J, D’Angelica M, Jarnagin W, et al. Selective use of diagnostic laparoscopy prior to planned hepatectomy for patients with hepatocellular carcinoma. Surgery 2004;135:273–81

    Article  PubMed  Google Scholar 

  15. Giger U, Schafer M, Krahenbuhl L. Technique and value of staging laparoscopy. Dig Surg 2002;19:473–8

    Article  PubMed  CAS  Google Scholar 

  16. D’Angelica M, Fong Y, Weber S, et al. The role of staging laparoscopy in hepatobiliary malignancy: Prospective analysis of 401 cases. Ann Surg Oncol 2003;10:183–9

    Article  PubMed  CAS  Google Scholar 

  17. Champault A, Dagher I, Vons C, et al. Laparoscopic hepatic resection for hepatocellular carcinoma. Retrospective study of 12 patients. Gastroenterol Clin Biol 2005;29:969–73

    Article  PubMed  Google Scholar 

  18. Morino M, Morra I, Rosso E, et al. Laparoscopic vs. open hepatic resection: A comparative study. Surg Endosc 2003;17:1914–8

    Article  PubMed  CAS  Google Scholar 

  19. Rau HG, Buttler E, Meyer G, et al. Laparoscopic liver resection compared with conventional partial hepatectomy – A prospective analysis. Hepatogastroenterology 1998;45:2333–8

    PubMed  CAS  Google Scholar 

  20. Cugat E, Olsina JJ, Rotellar F, et al. Initial results of the National Registry of laparoscopic liver surgery. Cir Esp 2005;78:152–60

    Article  PubMed  CAS  Google Scholar 

  21. Watanabe Y, Sato M, Ueda S, et al. Laparoscopic hepatic resection: A new and safe procedure by abdominal wall lifting method. Hepatogastroenterology 1997;44:143–7

    PubMed  CAS  Google Scholar 

  22. Intra M, Viani MP, Ballarini C, et al. Gasless laparoscopic resection of hepatocellular carcinoma (HCC) in cirrhosis. J Laparoendosc Surg 1996;6:263–70

    PubMed  CAS  Google Scholar 

  23. Belli G, Fantini C, D’Agostino A, et al. Laparoscopic liver resection without a Pringle maneuver for HCC in cirrhotic patients. Chir Ital 2005;57:15–25

    PubMed  Google Scholar 

  24. Cherqui D, Husson E, Hammoud R, et al. Laparoscopic liver resections: A feasibility study in 30 patients. Ann Surg 2000;232:753–62

    Article  PubMed  CAS  Google Scholar 

  25. Laurent A, Cherqui D, Lesurtel M, et al. Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg 2003;138:763–9

    Article  PubMed  Google Scholar 

  26. Buell JF, Thomas MJ , Doty TC, et al. An initial experience and evolution of laparoscopic hepatic resectional surgery. Surgery 2004;136:804–11

    Article  PubMed  Google Scholar 

  27. Vibert E , Perniceni T, Levard H, et al. Laparoscopic liver resection. Br J Surg 2006;93:67–72

    Article  PubMed  CAS  Google Scholar 

  28. Gigot JF, Glineur D, Azagra JS, et al. Laparoscopic liver resection for malignant liver tumors; Preliminary results of a multi-center European study. Ann Surg 2002;236:90–7

    Article  PubMed  Google Scholar 

  29. Cherqui D, Laurent A, Tayar C, et al. Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: Midterm results and perspectives. Ann Surg 2006;243:499–506

    Article  PubMed  Google Scholar 

  30. Kawamoto C, Ido K , Isoda N, et al. Long-term outcomes for patients with solitary hepatocellular carcinoma treated by laparoscopic microwave coagulation. Cancer 2005;103:985–93

    Article  PubMed  Google Scholar 

  31. O’Rourke N, Fielding G. Laparoscopic right hepatectomy: Surgical technique. J Gastrointest Surg 2004;8:213–6

    Article  PubMed  Google Scholar 

  32. Fong Y, Jarnagin W , Conlon KC, et al. Hand-assisted laparoscopic liver resection: Lessons from an initial experience. Arch Surg 2000;135:854–9

    Article  PubMed  CAS  Google Scholar 

  33. Huang MT, Lee WJ, Wang W, et al. Hand-assisted laparoscopic hepatectomy for solid tumor in the posterior portion of the right lobe: Initial experience. Ann Surg 2003;238:674–9

    Article  PubMed  Google Scholar 

  34. Inagaki H, Kurokawa T, Nonami T, et al. Hand-assisted laparoscopic left lateral segmentectomy of the liver for hepatocellular carcinoma with cirrhosis. J Hepatobiliary Pancreat Surg 2003;10:295–8

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Chen-Guo Ker MD, PhD, FACS.

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Chen, HY., Juan, CC. & Ker, CG. Laparoscopic Liver Surgery for Patients with Hepatocellular Carcinoma. Ann Surg Oncol 15, 800–806 (2008). https://doi.org/10.1245/s10434-007-9749-1

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  • DOI: https://doi.org/10.1245/s10434-007-9749-1

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