Laparoscopic liver resection for hepatocellular carcinoma: intermediate follow-up results

Laparoscopic hepatectomy (LH) has gained increased acceptance for the treatment of selected hepatocellular carcinoma (HCC). The technical consideration and long-term follow-up data of LH for hepatocellular carcinoma are limited. The current study presents the experience of 17 LH for HCC with a mean follow-up of 23 months.

From April 2003 to December 2005, we successfully performed 17 LH for patients with HCC. Patient demographics, peri-operative parameters and outcomes of the 17 patients were assessed retrospectively.

All 17 LH were performed smoothly without conversion to laparotomy. There was no operative mortality, but transfusion and relaparoscopy was required for one patient with internal bleeding 7 days after LH. The mean hospital stay was 10.9 (6-23) days. All but one patient had section margins longer than 1 centimeter. Four patients had tumor thrombi in portal vessels of their resected specimen. During the mean follow up of 23 months, five patients (29.4%) developed recurrence. Four of the recurrences limited in the liver, and one patient had both liver and lung metastasis. No port site or peritoneal metastases were observed. Treatment of recurrence was second resection in one patients and trans-arterial embolization therapy in four other patients. Mean disease-free survival was 19 months.

Laparoscopic hepatectomy is feasible in selected patients with single, smaller and peripherally-located hepatocellular carcinoma. The surgical morbidity and intermediate followup results seem satisfactory.