Laparoscopic liver resections for hepatocellular carcinoma (HCC) in cirrhotic patients

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

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The laparoscopic approach for liver resections is still limited and controversial. Nevertheless the advantages connected with a mini-invasive approach are significant, especially in cirrhotic patients. In recent years the progress of laparoscopic procedures and the development of new and dedicated technologies have made endoscopic hepatic surgery feasible and safe. The aim of this study was to report the results of our experience in laparoscopic liver surgery for hepatocellular carcinoma (HCC) in cirrhotic patients. Methods. From 2000 to 2003, 16 patients (10 male, 6 female; age 48-69 years; mean age 60.1 years) with HCC and associated severe but well compensated liver cirrhosis underwent laparoscopic hepatic resections at our department. Mean tumour size was 2.9 cm (range 1-3.9). Seven of these lesions were in the left liver and nine in the right lobe. Laparoscopy was performed under CO2 pneumoperitoneum. The liver was always examined using laparoscopic ultrasound (US) to confirm the extension of the lesions and their relationships to the vasculature. The Pringle manoeuvre was not used. The transection of liver parenchyma was obtained by the use of a harmonic scalpel. The specimens were placed in a plastic bag and removed without contact to the abdominal wall. Results. There was one conversion to laparotomy for inadequate exposure. In the remaining 15 patients we performed 13 non-anatomical resections, 1 segmentectomy and 1 anatomical left lobectomy. The mean operative time was 152 min (range 80-180). Mean blood loss was 280 ml and none of the patients required blood transfusions. In two patients the resection margin was

Original languageEnglish
Pages (from-to)236-246
Number of pages11
JournalHPB
Volume6
Issue number4
DOIs
Publication statusPublished - 2004

Keywords

  • Cirrhosis
  • HCC
  • Laparoscopy
  • Liver resection
  • Pringle manoeuvre

ASJC Scopus subject areas

  • Gastroenterology

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