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Related Experiment Video

Updated: Jul 12, 2025

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
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Appropriate indications for laparoscopic repeat hepatectomy.

Takashi Masuda1, Yuichi Endo2, Shota Amano2

  • 1Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan. tmasuda@oita-u.ac.jp.

BMC Surgery
|October 24, 2023
PubMed
Summary
This summary is machine-generated.

Laparoscopic repeat hepatectomy (LRH) is suitable for patients with prior laparoscopic partial hepatectomy and tumors in segments S2-6. For complex repeat hepatectomy (RH) involving more than segmentectomy, planned hand-assisted laparoscopic surgery (HALS) or open RH is preferred.

Keywords:
ConversionDifficulty scoreHALSLaparoscopic repeat hepatectomyRepeat hepatectomy

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Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Laparoscopic repeat hepatectomy (LRH) is increasingly utilized, yet its optimal indications remain undefined.
  • Clarifying appropriate patient selection for LRH is crucial for improving surgical outcomes.

Purpose of the Study:

  • To define the appropriate indications for performing laparoscopic repeat hepatectomy (LRH).

Main Methods:

  • A retrospective comparison of surgical outcomes between open repeat hepatectomy (ORH) and LRH.
  • Analysis of 6 cases with unplanned intraoperative hand-assisted laparoscopic surgery (HALS)/open conversion to identify challenging LRH scenarios.

Main Results:

  • LRH was more frequently associated with prior laparoscopic partial hepatectomy (75%) and tumors in segments S2-6 (73%) compared to ORH.
  • Cases requiring repeat hepatic hilar approach, indicative of more complex repeat hepatectomy (RH), were exclusively HALS conversions, suggesting limitations of pure LRH in such scenarios.

Conclusions:

  • Appropriate indications for LRH include prior laparoscopic partial hepatectomy and repeat hepatectomy for S2-6 tumors.
  • For repeat hepatectomy (RH) extending beyond segmentectomy, particularly requiring a repeat hepatic hilar approach, planned HALS or ORH may offer a safer alternative to pure LRH.