Laparoscopic Liver Resection for Hepatocellular Carcinoma, 5 year experience

Long Tran Cong Duy, MD, Bac Nguyen Hoang, MD, PhD, Thuan Nguyen Duc, MD, Dat Le Tien, MD, Viet Dang, MD

HBP Surgery

Background: The objective of this study was to evaluate the feasibility, safety and efficacy of laparoscopic liver resection for HCC in 5 year experience.

Patients and methods: Perspective and descriptive case series study.
For diagnosis and treatment for HCC, we followed AASLD (2005) guideline. Laparoscopic liver resection was indicated for the unique tumor < 5cm in the right side and < 10cm for the left side. Parameters (patient data, oparative time, blood transfusion, post-op complications and survival) were recorded according to the protocol and analised by SPSS 16.0.

Results: From Jan 2008 to Dec 20012, we performed totally laparoscopic liver resection for 194 HCC patients. According to BCLC, stages of disease were: Very early (1,1%), Early A1(60,8%), A2(5,8%), A4(3,2%) and B(29,1%). Succesful rate was 95,4%(185 patients). Conversion rate was 2.1%, Laparoscopic diagnostic operation in 5 patients (2.6%). Kinds of opeartions were show on below table. Laparoscopic anatomic hepatectomy in 82 patients (44.3%). Mean operative time 105 + 48 min (30 – 300 min). Mean blood lost was 166,5 + 187.6 ml (50ml to 1200ml). Most of our patients (97.8%) had no need for blood tranfusion. Surgical margins were free of cancer in 97,8%. Post-op complications: 2 (1.1%) had bile leakage, 2 (1.1%) with temporary liver failure, 1 patient had hemorrhage from the incision and 1 pneumonia. No mortality within 30 days after the operation. The overall and desease free survival rate after 1 and 3 year were 82,5%;76,2% and 60,5%;45,9%.

Conclusions: This study demonstrates that laparoscopic liver resection for hepatocellular carcinoma is feasible, safe, and effective with good oncologic results. By the time, major and anatomic hepatectomy can be more and more applied by improving skills and experience. Laparoscopic liver resection become promising potential treatment with mini invasive benefit for HCC patients.

Hepatectomy Position Frequency Percent
1 segmentectomy Segment 2 11 5.9
segment 3 8 4.3
segment 4 12 6.5
segment 5 13 7.0
segment 6 30 16.2
segment 7 8 4.3
segment 8 2 1.1
2 segmentectomy Posterior sector 8 4.3
Anterior sector 2 1.1
Lateral sector 1 0.5
segment 5,6 14 7.6
Left lobe 66 35.7
3 segmentectomy Left liver 7 3.8
4 segmentectomy Right liver 3 1.6
Total 185 100

Session: Podium Presentation

Program Number: S004

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