[A promising new procedure: laparoscopic devascularization for hepatocellular carcinoma with extra-hepatic feeding...

We have developed a new therapeutic modality: laparoscopic devascularization (LDEV) for hepatocellular carcinoma (HCC). Thirteen patients with HCC were treated with LDEV from March 1998 to March 2002. All LDEV procedures were performed under laparoscopic surgery using laparoscopic coagulating shears (LCS), endo-clip and endo-GIA. To prevent recanalization of extra-hepatic feeding arteries, we always add local ablation therapy (LAT) intraoperatively. The results are as follows. 1. The right gastroepiploic artery in 11 patients, right gastric artery in 1 and right inferior phrenic artery in 2 were devascularized. 2. The amount of intraoperative bleeding ranged 5-150 g and the operating time for devasculalization ranged 5-50 min, with an average of 30 min. 3. LAT was also performed in all cases. 4. No complications occurred. 5. A recurrent feeding artery developed in only one case (8%). 6. Nine patients are living (6-52, average 27 months) and 4 have died (5-28, average 16 months).