Preliminary Experience of Laparoscopic Hepatectomy for Hepatocellular Carcinoma

ABSTRACT

PURPOSE: Laparoscopic liver resection has gained much popularity in recent years, but relatively few centers have performed hepatectomies in hepatocellular carcinoma (HCC) patients due to the technical difficulties faced with underlying liver cirrhosis. We now present our early experience with laparoscopic liver resection in HCC performed in a single institution. METHODS: From October 2003 until March 2009, 39 laparoscopic liver resections were performed on HCC patients among whom 26 had underlying liver cirrhosis. RESULTS: The location of the tumor was in the left lateral section in 15, segment 5 or 6 in 20, segment 4 in 3 and caudate lobe in 1. Resection involving less than a monosegment was done in 26 and more than 2 segments in 13. Tumor size ranged from 0.8 cm to 6.6 cm (median 2.35) and the resection margin from 0.1 to 6 cm (median 1.5 cm). All patients were either stage I (29) or II (10). There was no difference between cirrhotic and non-cirrhotic patients in operation time (median 210 minutes, range 60~637), change of hematocrit value (4.8%, -1~19.6%), or hospital stay (8 days, 3~67 days). The median follow up duration was 15.1 months, and the 2-year recurrence free survival rate was 48.3%. CONCLUSION: Laparoscopic liver resection in HCC with or without underlying cirrhosis seems to be feasible with minimal morbidity, especially in well selected cases with early stage HCC.