Laparoscopic hepatic resection for completely exophytic hepatocellular carcinoma on cirrhosis

Giulio Belli, Corrado Fantini, Alberto D'Agostino, Andrea Belli, Serena Langella

Research output: Contribution to journalArticle

20 Citations (Scopus)

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 116min (range, 90-150min). 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.

Original languageEnglish
Pages (from-to)488-493
Number of pages6
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume12
Issue number6
DOIs
Publication statusPublished - Dec 2005

Fingerprint

Hepatocellular Carcinoma
Fibrosis
Liver
Laparoscopy
Pathology
Air Embolism
Segmental Mastectomy
Brain Diseases
Operative Time
Jaundice
Ascites
Blood Transfusion
Laparotomy
Fear
Therapeutics
Eating
Hemorrhage
Morbidity

Keywords

  • Cirrhosis
  • Exophytic HCC
  • Laparoscopic liver resection
  • Pringle maneuver

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic hepatic resection for completely exophytic hepatocellular carcinoma on cirrhosis. / Belli, Giulio; Fantini, Corrado; D'Agostino, Alberto; Belli, Andrea; Langella, Serena.

In: Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 12, No. 6, 12.2005, p. 488-493.

Research output: Contribution to journalArticle

Belli, Giulio ; Fantini, Corrado ; D'Agostino, Alberto ; Belli, Andrea ; Langella, Serena. / Laparoscopic hepatic resection for completely exophytic hepatocellular carcinoma on cirrhosis. In: Journal of Hepato-Biliary-Pancreatic Surgery. 2005 ; Vol. 12, No. 6. pp. 488-493.
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