Aim:Laparoscopic liver resection for hepatocellular carcinoma(HCC)is increasingly common around the world.There may be significant advantages over open resections.However,due to technical difficulties,they are perform...Aim:Laparoscopic liver resection for hepatocellular carcinoma(HCC)is increasingly common around the world.There may be significant advantages over open resections.However,due to technical difficulties,they are performed in few centers with expertise in liver and advanced laparoscopic surgery.In this study the authors summarize the experience to date.Methods:A retrospective analysis of consecutive patients undergoing laparoscopic liver resection for HCC in 2 tertiary academic hepatobiliary units in Brisbane,Australia,between 1999 and 2015 was performed.Operative characteristics,perioperative morbidity,and pathological data were described.Patients with and without cirrhosis were analyzed and compared.Results:F ifty-two p atients u nderwent r esection of 79 H CCs.Sixty-five percent of patients had cirrhosis.Fourteen percent of patients underwent a major hepatectomy.There was a trend towards more parenchyma-sparing resections for cirrhotic patients.Blood loss was higher in cirrhotics.Conversion to an open procedure occurred in 9%.There was one 90-day mortality due to liver failure(1.9%),and 7 patients(13%)experienced a complication.R0 resection was achieved in 92%.Overall survival at 1,3,and 5 years was 88%,81%,and 61%,respectively.Conclusion:Laparoscopic liver resection for HCC,particularly in cirrhotic patients,is technically challenging.It can be performed with acceptable morbidity and adequate surgical margins.展开更多
文摘Aim:Laparoscopic liver resection for hepatocellular carcinoma(HCC)is increasingly common around the world.There may be significant advantages over open resections.However,due to technical difficulties,they are performed in few centers with expertise in liver and advanced laparoscopic surgery.In this study the authors summarize the experience to date.Methods:A retrospective analysis of consecutive patients undergoing laparoscopic liver resection for HCC in 2 tertiary academic hepatobiliary units in Brisbane,Australia,between 1999 and 2015 was performed.Operative characteristics,perioperative morbidity,and pathological data were described.Patients with and without cirrhosis were analyzed and compared.Results:F ifty-two p atients u nderwent r esection of 79 H CCs.Sixty-five percent of patients had cirrhosis.Fourteen percent of patients underwent a major hepatectomy.There was a trend towards more parenchyma-sparing resections for cirrhotic patients.Blood loss was higher in cirrhotics.Conversion to an open procedure occurred in 9%.There was one 90-day mortality due to liver failure(1.9%),and 7 patients(13%)experienced a complication.R0 resection was achieved in 92%.Overall survival at 1,3,and 5 years was 88%,81%,and 61%,respectively.Conclusion:Laparoscopic liver resection for HCC,particularly in cirrhotic patients,is technically challenging.It can be performed with acceptable morbidity and adequate surgical margins.
