Tan To Cheung, MS. The University of Hong Kong Queen Mary Hospital
Introduction
Bleeding in the presence of thrombocytopenia has been a major issue in liver resection even in open procedures. Although laparoscopic liver resection has been reported to be a safe and effective treatment even in patients with liver cirrhosis, there is very little evidence on patients with thrombocytopenia.
Method: Between October 2002 and September 2015, 131 patients had undergone curative pure laparoscopic liver resection for solitary hepatocellular carcinoma (HCC). Thrombocytopenia was define as platelet counts <100x 109/L. Amongst 131, patients received laparoscopic liver resection, 16 patients had platelet count <100x 109/L (Group 1). Another 116 patients with platelet count equal or more than 100x 109/L (Group 2). The immediate operation outcome and survival including operation morbidity, were compared. The disease free survival and median survival were also compared.
Results:
Comparing Group1 to Group 2, the median operation time was 184 minutes vs 175 minutes p=0.582, the median blood loss was 200 ml vs 100 ml (P=0.189). 1 patient (6.3%) from Group 1 had blood transfusion and 3 patients (2.9%) from Group 2 had blood transfusion. (p=1) The hospital stay was 4 days vs 4 days (P=0.984), postoperative complication was 3 (18.8%) vs 8(7.8%) (p=0.351), There was no hospital mortality in both groups of patients. The overall median survival was >114.1 months vs 136.1 months (P=0.289).
Conclusion:
Pure laparoscopic liver resection is a safe treatment option for HCC. Good outcome is observed in patients even with low platelet count.
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