Resezioni epatiche laparoscopiche per HCC su cirrosi senza manovra di Pringle.

Translated title of the contribution: Laparoscopic liver resection without a Pringle maneuver for HCC in cirrhotic patients

Giulio Belli, Corrado Fantini, Alberto D'Agostino, Andrea Belli, Nadia Russolillo, Luigi Cioffi

Research output: Contribution to journalArticlepeer-review

Abstract

In the belief that the advantages stemming from a minimally invasive approach are significant, particularly in cirrhosis patients, we decided to apply this technique in the treatment of a group of patients suffering from HCC associated with cirrhosis. Sixteen patients (10 men, 6 women; mean age 60.1 years) underwent laparoscopic surgery for HCC associated with well compensated HCV-related liver cirrhosis (Child-Pugh class A; mean tumour size 2.9 cm). Seven of these lesions were located in the left liver and 9 in the right lobe. Laparoscopy was performed with a CO2 pneumoperitoneum (12-14 mmHg). The Pringle manoeuvre was not used. There was one conversion to laparotomy due to inadequate exposure. We performed 13 non-anatomical resections, 1 VI segmentectomy and 1 anatomical left lobectomy. None of the patients required blood transfusions. One patient died of severe respiratory distress syndrome on postoperative day 3. Major morbidity included 2 moderate postoperative ascites successfully resolved with conservative treatment. To date (mean follow-up: 18 months) no recurrences at the resection site or port-site metastases have been observed. Limited laparoscopic liver resections for HCC in cirrhotic patients are technically feasible and safe when careful selection criteria are adopted (hepatic involvement limited and located in the left or anterior right segments, tumour size smaller than 5 cm, Child-Pugh class A).

Translated title of the contributionLaparoscopic liver resection without a Pringle maneuver for HCC in cirrhotic patients
Original languageItalian
Pages (from-to)15-25
Number of pages11
JournalChirurgia Italiana
Volume57
Issue number1
Publication statusPublished - Jan 2005

ASJC Scopus subject areas

  • Surgery

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