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Updated: Jun 10, 2025
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Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
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Laparoscopic central hepatectomy: Feasibility and safety.
Tiing-Foong Siow1,2, Chiung-Hui Hsieh2, U-Chon Chio2
1Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
Surgical Endoscopy
|October 18, 2024
Summary
Laparoscopic central hepatectomy (CH) is a safe and effective parenchymal-sparing alternative for centrally located hepatocellular carcinoma (HCC). This approach reduces postoperative complications and hospital stay compared to major hemihepatectomy (HH), while offering comparable long-term survival.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Minimally invasive surgery
Background:
- Anatomical liver resection is standard for hepatocellular carcinoma (HCC).
- Centrally located HCC often requires risky major resections.
- Central hepatectomy (CH) is a parenchymal-sparing alternative to hemihepatectomy (HH) for central tumors, potentially reducing liver failure risk.
Purpose of the Study:
- To evaluate the feasibility and safety of laparoscopic central hepatectomy (CH) for centrally located HCC.
- To compare surgical outcomes of laparoscopic CH with laparoscopic hemihepatectomy (HH).
Main Methods:
- Retrospective review of 1592 laparoscopic hepatectomy cases (January 2011-April 2023).
- Comparison of 70 laparoscopic CH cases with 32 laparoscopic HH cases.
- Exclusion of non-HCC, non-central tumors, and combined procedures.
Main Results:
- Laparoscopic CH and HH showed similar blood loss, transfusion rates, and operation times.
- CH group had shorter hospital stays (6 vs. 9 days), fewer ICU transfers (19% vs. 44%), and lower 90-day mortality (1% vs. 9%).
- Overall complication rates were similar, but HH had more minor complications; long-term survival favored CH.
Conclusions:
- Laparoscopic CH is a feasible and safe option for centrally located HCC.
- It offers comparable perioperative outcomes and favorable long-term survival versus HH.
- CH is a viable liver-preserving approach for selected HCC patients.
