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Optimal introduction of laparoscopic liver resection for Child-Pugh B

Hiroaki Fuji1, Satoru Seo1, Rei Toda1

  • 1Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Asian Journal of Endoscopic Surgery
|August 23, 2018
PubMed

Insights

Laparoscopic liver resection (LLR) is minimally invasive for Child-Pugh B liver malignancy. Lesions in the left lateral segment and exophytic tumors are suitable indications for LLR in these patients.

Area of Science:

  • Hepatobiliary surgery
  • Minimally invasive surgical techniques
  • Oncology

Background:

  • Child-Pugh B liver function presents high surgical risks.
  • Indications for laparoscopic liver resection (LLR) in Child-Pugh B patients remain unclear.
  • This study evaluates LLR outcomes in Child-Pugh B patients.

Purpose of the Study:

  • To determine optimal indications for LLR in Child-Pugh B patients.
  • To compare LLR outcomes with other liver resection methods.
  • To assess the safety and efficacy of LLR for liver malignancy in Child-Pugh B patients.

Main Methods:

  • Retrospective cohort study of 17 Child-Pugh B patients undergoing LLR (2005-2017).
  • Comparison with LLR in Child-Pugh A patients (103 cases).
  • Outcomes compared to open liver resection (19 cases) and radiofrequency ablation (RFA) (20 cases) in Child-Pugh B patients.

Main Results:

  • LLR in Child-Pugh B had a higher conversion rate (35.3%) than in Child-Pugh A (3.9%).
  • Successful LLR in Child-Pugh B patients showed reduced postoperative ascites and shorter hospital stays versus open resection.
  • LLR was associated with more left lateral segment and exophytic tumors, lower local recurrence, and longer recurrence-free survival compared to RFA.

Conclusions:

  • LLR offers minimal invasiveness for Child-Pugh B liver malignancy.
  • Left lateral segment lesions and exophytic tumors are favorable indications for LLR in Child-Pugh B.
  • LLR is a viable option for select Child-Pugh B patients with liver malignancy.
Abstract

Keywords:
Child-Pugh BRFAlaparoscopic liver resection

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