Pure laparoscopic hepatectomy for hepatocellular carcinoma patients with severe liver cirrhosis.

Z. Morise, A. Sugioka, N. Kawabe, S. Umemoto, H. Nagata, H. Ohshima, J. Kawase, S. Arakawa, R. Yoshida

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Hepatocellular carcinoma often arises in cirrhotic livers. Patients with severe liver cirrhosis who undergo hepatectomy often develop postoperative liver failure, even if the hepatectomy is limited. Here, we report six patients with severe liver cirrhosis (Child-Pugh B/C and indocyanine green retention rate at 15 min ≥ 40%) who underwent pure laparoscopic hepatectomy. Their perioperative course was favorable and comparable to that of other hepatocellular carcinoma patients with mild-moderate liver cirrhosis. In patients with severe liver cirrhosis, pure laparoscopic hepatectomy minimizes the disturbance in collateral blood and lymphatic flow caused by laparotomy and liver mobilization, as well as the mesenchymal injury caused by compression of the liver. It limits complications such as massive ascites, which can lead to severe postoperative liver failure. Good candidates for the procedure include patients with severe liver cirrhosis who have tumors on the liver surface and in whom adaptation to ablation therapy is difficult and/or who experience local recurrence after repeat treatments.

Original languageEnglish
Pages (from-to)143-146
Number of pages4
JournalAsian journal of endoscopic surgery
Volume4
Issue number3
DOIs
Publication statusPublished - 08-2011

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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