Laparoscopic Liver Resection for Hepatocellular Carcinoma

Ka-Jeong Kim; Chi-Young Jeong; Sang-Ho Jeong; Young-Tae Ju; Eun-Jung Jung; Young-Joon Lee; Sang-Kyung Choi; Woo-Song Ha; Soon-Tae Park; Soon-Chan Hong

doi:10.4174/jkss.2011.80.1.51

Journal List > J Korean Surg Soc > v.80(1) > 1011266

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Kim, Jeong, Jeong, Ju, Jung, Lee, Choi, Ha, Park, and Hong: Laparoscopic Liver Resection for Hepatocellular Carcinoma

Original Article

Journal of Korean Spine Surg 2011;80(1):51-55.

Published online: 4 February 2011

DOI: https://doi.org/10.4174/jkss.2011.80.1.51

Laparoscopic Liver Resection for Hepatocellular Carcinoma

Ka-Jeong Kim, M.D., Chi-Young Jeong, M.D., Sang-Ho Jeong, M.D., Young-Tae Ju, M.D., Eun-Jung Jung, M.D., Young-Joon Lee, M.D., Sang-Kyung Choi, M.D., Woo-Song Ha, M.D., Soon-Tae Park, M.D., Soon-Chan Hong, M.D.

Department of Surgery of Cyeongsang National University School of Medicine, Jinju, Korea

책임저자: 홍순찬, 경남 진주시 칠암동 90번지? 660-702, 경상대학교 의학전문대학원 외과학교실 Tel: 055-750-8096, Fax: 055-750-8732 E-mail: hongsc@nongae.gnu.ac.kr

Received 13 August 2010 Accepted 4 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

With the advancement of laparoscopic instruments and accumulation of surgical technique, laparoscopic liver resection is currently performed for various benign and malignant liver diseases. However, controversies still remain over laparoscopic liver resection for malignant liver diseases including HCC and its oncologic safety is yet to be established. This study aims at determining the safety, feasibility and short-term oncologic outcomes of laparoscopic liver resection performed for HCC.

Methods

From July 2008 to March 2010, laparoscopic liver resection was performed at our hospital on a total of 45 patients with various benign and malignant liver diseases. Among these 45 patients, 16 patients diagnosed with HCC were reviewed retrospectively.

Results

The mean age of the patients was 59.25, comprising 11 male patients (68.8%) and 5 female patients (31.2%). The location of tumor was left lateral in 7 cases, 4 cases in segment 6, 2 cases in segment 7, 2 cases in segment 5, 1 case in segment 4 and 1 case in caudate lobe. Wedge resection was performed in 11 cases, left hemi hepatectomy in 2 cases, left lateral sectionectomy in 2 cases, caudate lobectomy in 1 case. The mean operative time was 248.75 minutes. The mean hospital stay was 13.8 days, and there were no postoperative recurrences during the postoperative follow-up period.

Conclusion

When performed by expert surgeons in selected patients, laparoscopic liver resection for HCC is a feasible and safe procedure.

Keywords: Hepatocellular carcinoma, Liver resection, Laparoscopy

References

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Table 1.

Characteristics of 16 patients

Variable
Age	59.3 (42∼74)
Gender	M： F=11：5
Liver status
Liver cirrhosis, n (%)	12 (75%)
Non-cirrhotic liver, n (%)	4 (25%)
Hepatitis status
Hepatitis B carrier, n (%)	10 (62.5%)
Hepatitis C carrier, n (%)	1 (6.25%)
None, n (%)	5 (31.25%)
Child-Pugh classification
Class A, n (%)	12 (100%)
Class B, n (%)	0
Class C, n (%)	0

Table 2.

Types of liver resection and int raoperative results

Variable
Type of liver resection
Left hemihepatectomy, n (%)	2 (12.5%)
Left lateral sectionectomy, n (%)	2 (12.5%)
Caudate lobectomy, n (%)	1 (6.3%)
Wedge resection, n (%)	11 (68.7%)
Operative time (min)	248.75 (40∼400)
Intraoperative transfusion, n (%)	10 (62.5%)
Open conversion n (%)	5 (31.3%)
Bleeding, n (%)	5 (100%)

Table 3.

Postoperative results

Variable
Mortality	0 (0%)
Complication	5 (31.3%)
Intra-abdominal fluid collection	2
Ascites (＞500 ml/day)	1
Colonic fistula	1
Wound infection	1
Gas out (postoperative day)	2.1 (1∼3)
Oral intake (postoperative day)	2.2 (1∼4)
Hospital stay (postoperative day)	13.8 (7∼71)
Recurrence, n (%)	0 (0%)

Table 4.

Tumor characteristics

Variable
Tumor size (cm)	2.59 (1.3∼6.5)
Single lesion/multiple lesion	14/2
Location of tumor
Left lateral	7
Segment 6	4
Segment 7	2
Segment 5	5
Segment 4	4
Caudate lobe	1
R0 resection, n(%)	16 (100%)
Surgical margins for those with R0 resection (cm)	1.78 (0.3∼4.5)

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