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Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients
Author(s) -
Kaneko Hironori,
Tsuchiya Masaru,
Otsuka Yuichiro,
Yajima Satoshi,
Minagawa Teruaki,
Watanabe Masashi,
Tamura Akira
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-009-0123-5
Subject(s) - hepatectomy , medicine , cirrhosis , hepatocellular carcinoma , laparoscopy , surgery , gastroenterology , general surgery , resection
Abstract Introduction We have used laparoscopic hepatectomy as a surgical treatment for HCC in patients with cirrhosis. We describe the indications, evaluate invasiveness and analyze the outcomes of laparoscopic hepatectomy. Methods and Results With respect to operative method, laparoscopic hepatectomy involving either partial hepatectomy or left lateral sectionectomy is a less invasive procedure in patients with cirrhosis than conventional hepatectomy. Among our laparoscopic hepatectomy cases, operative time was shorter and bleeding was less in recent, as compared to earlier, cases. Furthermore, laparoscopic hepatectomy was less invasive than conventional hepatectomy, as determined by the E‐PASS scoring system. Patients also recovered more quickly, which resulted in shorter hospital stays even for patients with cirrhosis. Both the 5‐year survival rate and the rate of survival without recurrence of HCC were nearly identical to those of open conventional hepatectomy. Conclusion These findings indicate that laparoscopic hepatectomy avoids the disadvantages of standard hepatectomy for HCC in properly selected patients with cirrhosis and that its minimal invasiveness improves patients’ quality of life.