Abstract
Laparoscopic surgery is a relatively new option for the treatment of hepatocellular carcinoma (HCC) on cirrhosis. To date, there have been only a few reports of this option for this pathology in the literature, probably because of the intra operative difficulties related to the treatment of this pathology (even at laparotomy) and because of the problems related to the minimally invasive approach (technical difficulties, complicated management of the bleeding, lack of dedicate tools, and fear of gas embolism). In this article we report four patients from our whole series (23 laparoscopic liver resections for HCC) who underwent a laparoscopic resection for completely exophytic HCC on cirrhosis, located in segment IV in two patients, and in segment III and segment V respectively, in the other two. The mean operative time was 116 min (range, 90–150 min). The Pringle maneuver was never performed. No blood transfusions were needed. No postoperative complications occurred, neither ascites, nor jaundice, nor encephalopathy. Postoperative liver function returned to the preoperative level within 3 days. Food intake started on postoperative day 2. The patients were discharged on postoperative days 5 (one patient), 6 (two patients), and 7 (one patient) after uncomplicated courses. In our opinion, limited laparoscopic liver resections could be considered, at present, to be the best option for the treatment of extremely rare protruding HCC on cirrhosis. We believe that a minimally invasive approach can minimize the postoperative morbidity rate, which is still too high in this group of patients. Our experience confirmed that nonanatomical limited resections or anatomical left lateral segmentectomies for HCC on cirrhosis are feasible and safe in the hands of surgeons trained in both open liver surgery and advanced laparoscopic surgery.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
G Samama L Chiche JL Brefort Y Le Roux (1998) ArticleTitleLaparoscopic anatomical hepatic resection. Report of four left lobectomies for solid tumors Surg Endosc 12 76–78 Occurrence Handle9419311 Occurrence Handle10.1007/s004649900599 Occurrence Handle1:STN:280:DyaK1c%2Fos1ygsQ%3D%3D
CGS Huscher C Napolitano S Chiodini A Recher PF Buffa MM Lirici (1997) ArticleTitleHepatic resections through the laparoscopic approach Ann Ital Chir 6 791–797
H Kaneko S Takagi T Shiba (1996) ArticleTitleLaparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series Surgery 120 468–475 Occurrence Handle8784399 Occurrence Handle1:STN:280:BymA2sfotlI%3D
J Marks J Mouiel N Katkhouda J Gugenheim P Fabiani (1998) ArticleTitleLaparoscopic liver surgery. A report on 28 patients Surg Endosc 12 331–334 Occurrence Handle9543523 Occurrence Handle10.1007/s004649900664 Occurrence Handle1:STN:280:DyaK1c3hvFChsA%3D%3D
D Cherqui E Husson R Hammoud B Malassagne F Stephan S Bensaid et al. (2000) ArticleTitleLaparoscopic liver resections: a feasibility study in 30 patients Ann Surg 232 753–762 Occurrence Handle11088070 Occurrence Handle1:STN:280:DC%2BD3M%2FltVyntQ%3D%3D
HG Rau (1998) ArticleTitleLaparoscopic liver resections compared with conventional partial hepatectomy. A prospective analysis Hepatogastroenterology 45 2333–2338 Occurrence Handle9951918 Occurrence Handle1:STN:280:DyaK1M7jsFeruw%3D%3D
M Lesurtel D Cherqui A Laurent C Tayar PL Fagniez (2003) ArticleTitleLaparoscopic versus open left lateral hepatic lobectomy: a case-control study J Am Coll Surg 196 236–242 Occurrence Handle12595052 Occurrence Handle10.1016/S1072-7515(02)01622-8
M Morino I Morra E Rosso C Miglietta C Garrone (2003) ArticleTitleLaparoscopic vs open hepatic resection. A comparative study Surg Endosc 17 1914–1918 Occurrence Handle14574547 Occurrence Handle1:STN:280:DC%2BD2c%2FosVSisw%3D%3D
A Laurent D Cherqui M Lesurtel F Brunetti C Tayar PL Fagniez (2003) ArticleTitleLaparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease Arch Surg 138 763–769 Occurrence Handle12860758
D Cherqui (2003) ArticleTitleLaparoscopic liver resection Br J Surg 90 644–646 Occurrence Handle12808610 Occurrence Handle10.1002/bjs.4197 Occurrence Handle1:STN:280:DC%2BD3s3psV2hsA%3D%3D
G Belli (2004) ArticleTitleLaparoscopic liver surgery. (guest editorial) HPB 6 195–196
G Belli C Fantini A D'Agostino A Belli N Russolillo (2004) ArticleTitleLaparoscopic liver resections for hepatocellular carcinoma (HCC) in cirrhotic patients HPB 6 236–246
G Grazi G Ercolani F Pierangeli M Del Gaudio M Cescon A Cavallari et al. (2001) ArticleTitleImproved results of liver resection for hepatocellular carcinoma on cirrhosis give the procedure added value Ann Surg 234 71–78 Occurrence Handle11420485 Occurrence Handle10.1097/00000658-200107000-00011 Occurrence Handle1:STN:280:DC%2BD3MzlvFChtg%3D%3D
G Belli A D'Agostino F Ciciliano C Fantini N Russolillo A Belli (2002) ArticleTitleLiver resection for hepatic metastases: a 15-year experience J Hepatobiliary Pancreat Surg 9 607–613 Occurrence Handle12541048 Occurrence Handle10.1007/s005340200082
G Belli G Romano A Iannelli A D'Agostino I Marano (1999) ArticleTitleHepatic resection and percutaneous alcohol injection for the treatment of selected patients with more than one hepatocellular carcinoma Eur J Surg 165 647–651 Occurrence Handle10452258 Occurrence Handle1:STN:280:DyaK1MznvFehtQ%3D%3D
G Belli F Ciciliano A Iannelli A D'Agostino I Marano (2000) ArticleTitleEighty-four consecutive hepatic resections for hepatocellular carcinoma (H.C.C) HPB 2 228–229
B Descottes F Lachachi M Sodji D Valleix S Durand-Fortanier B Pech de Laclause et al. (2000) ArticleTitleEarly experience with laparoscopic approach for solid liver tumors: initial 16 cases Ann Surg 232 641–645 Occurrence Handle11066134 Occurrence Handle1:STN:280:DC%2BD3crhtF2ruw%3D%3D
J Mouiel N Katkhouda J Gugenheim P Fabiani (2000) ArticleTitleLaparoscopic surgery for hepatobiliary pancreatic disease: possibilities of laparoscopic liver resection J Hepatobiliary Pancreat Surg 7 1–8 Occurrence Handle10982584 Occurrence Handle10.1007/s005340050146 Occurrence Handle1:STN:280:DC%2BD3cvntV2jtQ%3D%3D
MY Abdel-Atty O Farges P Jagot J Belghiti (1999) ArticleTitleLaparoscopy extends the indications for liver resection in patients with cirrhosis Br J Surg 86 1397–1400 Occurrence Handle10583285 Occurrence Handle10.1046/j.1365-2168.1999.01283.x Occurrence Handle1:STN:280:DC%2BD3c%2FltFWrsA%3D%3D
CG Ker HY Chen CC Juan WS Chang CY Tsai HW Lo et al. (2000) ArticleTitleLaparoscopic subsegmentectomy for hepatocellular carcinoma with cirrhosis Hepato gastroenterology 47 1260–1263 Occurrence Handle11100327 Occurrence Handle1:STN:280:DC%2BD3Mzgs1yrsA%3D%3D
JF Gigot D Glineur JS Azagra M Goergen M Ceuterick M Morino et al. (2002) ArticleTitleLaparoscopic liver resection for malignant liver tumors. Preliminary results of a multicenter European study Ann Surg 236 90–97 Occurrence Handle12131090 Occurrence Handle10.1097/00000658-200207000-00014
SE Burpee M Kurian Y Murakame S Benevides M Gagner (2002) ArticleTitleThe metabolic and immune response to laparoscopic vs open liver resection Surg Endosc 16 899–904 Occurrence Handle12163951 Occurrence Handle10.1007/s00464-001-8122-x Occurrence Handle1:STN:280:DC%2BD38vgvFGnsQ%3D%3D
Author information
Authors and Affiliations
About this article
Cite this article
Belli, G., Fantini, C., D'Agostino, A. et al. Laparoscopic hepatic resection for completely exophytic hepatocellular carcinoma on cirrhosis. J Hepatobiliary Pancreat Surg 12, 488–493 (2005). https://doi.org/10.1007/s00534-005-1006-z
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00534-005-1006-z