Laparoscopic repeat liver resection for hepatocellular carcinoma: a multicentre propensity score-based study.

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Oncology

Background:

• Indications and outcomes for repeat liver resection in hepatocellular carcinoma (HCC) are not well-established due to limited data.
• This study addresses the uncertainty surrounding laparoscopic repeat liver resection for HCC.

Purpose of the Study:

• To define the current indications for laparoscopic repeat liver resection in HCC patients.
• To evaluate the outcomes of laparoscopic versus open repeat liver resection for HCC.

Main Methods:

• Data from 42 international liver surgery centers were collected for patients undergoing repeat liver resection for HCC.
• Patient and tumor characteristics, liver function, surgical approach, and outcomes were recorded.

Main Results:

• Laparoscopic surgery was used in patients with poorer performance status and liver function but favorable tumors.
• Compared to open surgery, laparoscopy showed significantly reduced blood loss, operation time, morbidity, and hospital stay.
• Propensity score matching confirmed less blood loss and longer operation time with laparoscopy, alongside similar survival outcomes.

Conclusions:

• Laparoscopic repeat liver resection is a viable option for carefully selected patients with recurrent HCC.
• The procedure demonstrates safety and efficacy, offering potential benefits over open surgery.