Laparoscopic Liver Resection for T1 and T2 Hepatocellular Carcinoma

Sanghyun Song, MD, Chood Hyuck David Kwon, MD, Jae Won Joh, MD, Milljae Shin, MD, Jong Man Kim, MD, Sung Joo Kim, MD, Suk Koo Lee, MD, Young Nam Roh, MD, Hyung Hwan Moon, MD, Sanghoon Lee, MD, Tae Seok Kim, MD. Department of surgery, Samsung Medical Center, Sungkyunkwan university school of medicine

Purpose: Laparoscopic liver resection has gained much popularity in recent years, but relatively few centers have performed hepatectomies in hepatocellular carcinoma (HCC) patients due to the technical difficulties. We now present our early experience
with laparoscopic liver resection in HCC performed in a single institution
Methods: From January 2008 until February 2011, total 251 patients of hepatectomy was done and we excluded 20 stage 3 patients. Among 231 patients, 71 laparoscopic liver resections were performed. Open conversion was 13 cases(15.4%).
Results: The cause of open conversion were bleeding for 7 cases, inability to find a mass for 3 cases, severe adhesion for 2 cases and tumor margin for 1 case. In open resection group, T2 stage(60.9% vs 36.6%) and major operation(45.6% vs 16.9%) was more than in laparoscopic resection group. In laparoscopic resection group, admission duration(8.9 days vs 15.3 days, p=0.000), operation time(225.4min vs 299.4min, p=0.000), transfusion amount(0.06unit vs 0.36unit, p=0.005) were less than open resection group. When we analyzed stage 1 cases, cumulative disease free survival was comparable in both group. Median disease free survival was 18.9 months(range 1-39.8month) in open resection group and 19.4 months(range 1-39.4month) in laparoscopic resection group.(p=0.470) In stage 2 cases, median disease free survival was 14.23months(range 1-39.8month) in open resection group and 19.40months(range 1-37.9month) in laparoscopic resection group.(p=0.980)
Conclusion: Laparoscopic liver resection for HCC can be a feasible and safe operative method. Randomized control study is needed.
 

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