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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Laparoscopic liver resection for hepatocellular carcinoma
Ibrahim Dagher1, Panagiotis Lainas, Alessio Carloni
1Department of General Surgery, Antoine Beclere Hospital, 157 Avenue de la Porte de Trivaux, Clamart, France. ibrahim.dagher@abc.aphp.fr
Surgical Endoscopy
|August 21, 2007
Summary
Laparoscopic liver resection for small hepatocellular carcinoma (HCC) is safe and effective. This minimally invasive approach offers comparable oncological outcomes to open surgery, with reduced complications for patients with cirrhosis.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Partial liver resection is indicated for single, small hepatocellular carcinomas (HCC) in patients not eligible for transplantation.
- Anatomical resections are preferred for oncological reasons.
- Laparoscopy may reduce hepatic and parietal injury, potentially lowering risks of liver failure and ascites, but oncological outcomes and benefits require validation.
Purpose of the Study:
- To evaluate the short- and midterm outcomes of laparoscopic liver resections for HCC.
- To assess the feasibility, safety, and oncological efficacy of the laparoscopic approach for HCC.
Main Methods:
- A retrospective analysis of 32 laparoscopic liver resections for HCC performed between 1999 and 2006.
- Patients had a mean tumor size of 3.8 cm; 22 had cirrhosis (21 Child A, 1 Child C).
- Operative, postoperative, recurrence, and survival data were analyzed.
Main Results:
- Various resection types were performed, with a mean operative time of 231 minutes and mean blood loss of 461 ml.
- Conversion to laparotomy occurred in 9% of cases; 15.6% required blood transfusion.
- Mean follow-up was 26 months, with a 3-year overall survival of 71.9% and disease-free survival of 54.5%. No port-site recurrences were observed.
Conclusions:
- Laparoscopic liver resection for HCC is technically feasible and well-tolerated.
- The oncological results, including midterm survival and recurrence rates, appear comparable to traditional laparotomy.
- This approach offers a viable minimally invasive option for HCC treatment.
