The Usefulness of Laparoscopy-Assisted Hepatectomy for Metastatic Liver Tumor and Hepatocellular Carcinoma

Go Oshima, MD, Osamu Itano, MD, Yoshiaki Shoji, MD, Shingo Maeda, MD, Yasumasa Koyama, MD, Satoshi Aiko, MD, Yuko Kitagawa, Prof. Eiju General Hospital


Background and Aims: In this decade, laparoscopy-assisted hepatectomy has been rapidly spreading because of its less-invasiveness. Because metastatic liver tumor and hepatocellular carcinoma (HCC) often need repeated operation, minimally-invasive laparoscopy-assisted hepatectomy have a number of advantages to keep the damage and the period for subsequent therapy at a minimum. Herein we present our experiences of laparoscopy-assisted hepatectomy for the treatment of metastatic liver tumor and HCC and evaluate its usefulness.
Methods: We retrospectively analyzed the clinical outcomes of 41 patients who had undergone laparoscopy-assisted hepatic resection for metastatic liver tumor and HCC from January 2006 to March 2011 at Eiju General Hospital. We adopted laparoscopy-assisted hepatectomy appropriately, in consideration of adhesion due to surgery for primary disease or incision for simultaneous resection of primary disease.
Results: Twenty three and 18 laparoscopy-assisted hepatectomy for treatment of metastatic liver tumor and HCC were carried out. Metastatic liver tumors included 15 metastases of colon cancer, 1 metastasis of ovarian carcinoma, 1 metastasis of gastrointestinal stromal tumor of jejunum, 1 metastasis of breast cancer. The patients were composed of 25 men and 16 women. The patients’ mean age was 67.7 ± 9.9 years. Tumor mean size was 3.7 cm (range: 1.0 cm to 10 cm). There were 21 partial hepatectomy, 3 lateral sectionectomy, 3 anterior sectionectomy, 3 posterior sectionectomy, 2 left hepatectomy and 9 right hepatectomy. The operation consisted of laparoscopic mobilization of the target liver lobe, followed by open liver resection through a 8-12 cm extraction site. The mean operative time was 390 ± 124 minutes and 3 patient had blood transfusion. There were no intraoperative complications and no conversion to conventional open method. Mean postoperative hospital stay was 16 ± 13 days. There were no critical postoperative complications which need intensive therapy and no postoperative mortality.
Conclusion: Our experiences indicated that laparoscopy-assisted hepatectomy was a safe and useful option in the treatment of metastatic liver tumor and HCC. More accumulation of data may be needed for evaluation of long-term outcome.

Session Number: Poster – Poster Presentations
Program Number: P350
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