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World J Hepatol. Sep 27, 2013; 5(9): 487-495
Published online Sep 27, 2013. doi: 10.4254/wjh.v5.i9.487
Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease
Zenichi Morise, Norihiko Kawabe, Jin Kawase, Hirokazu Tomishige, Hidetoshi Nagata, Hisanori Ohshima, Satoshi Arakawa, Rie Yoshida, Masashi Isetani
Zenichi Morise, Norihiko Kawabe, Jin Kawase, Hirokazu Tomishige, Hidetoshi Nagata, Hisanori Ohshima, Satoshi Arakawa, Rie Yoshida, Masashi Isetani, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi 454-8509, Japan
Author contributions: Kawabe N, Kawase J, Tomishige H, Nagata H, Ohshima H, Arakawa S, Yoshida R and Isetani M collected the data and assisted in writing of the manuscript; Morise Z wrote the manuscript.
Correspondence to: Zenichi Morise, MD, PhD, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, 3-6-10, Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan. zmorise@aol.com
Telephone: +81-52-3218171 Fax: +81-52-3234502
Received: May 11, 2013
Revised: July 26, 2013
Accepted: August 17, 2013
Published online: September 27, 2013
Processing time: 143 Days and 5.4 Hours
Core Tip

Core tip: For cirrhotic patients with liver tumor, pure laparoscopic hepatectomy minimizes destruction of the collateral blood/lymphatic flow from laparotomy and mobilization, and has advantage of minimal postoperative ascites. It restrains the complications, which trigger the postoperative liver failure. The partial resection in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated with good vision and manipulation in the small operative field. Furthermore, repeat pure laparoscopic hepatectomy for patients with multicentric/metachronous hepatocellular carcinomas was feasible and safe with the advantages of less post-operative adhesion and good vision and manipulation between the adhesions.