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World J Surg Proced. Mar 28, 2015; 5(1): 137-141
Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.137
Laparoscopic liver resection for the treatment of hepatocellular carcinoma
Norihiko Kawabe, Zenichi Morise, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Masashi Isetani
Norihiko Kawabe, Zenichi Morise, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Masashi Isetani, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan
Author contributions: Kawabe N and Morise Z wrote the manuscript; Tomishige H, Nagata H, Kawase J, Arakawa S and Isetani M collected the data and assisted in writing the manuscript.
Conflict-of-interest: There is no conflict of interest that is related to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zenichi Morise, MD, PhD, FACS, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Aichi, Nagoya 454-8509, Japan. zmorise@fujita-hu.ac.jp
Telephone: +81-52-3235680 Fax: +81-52-3234502
Received: September 27, 2014
Peer-review started: September 28, 2014
First decision: December 17, 2014
Revised: December 29, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: March 28, 2015
Processing time: 187 Days and 7.4 Hours
Abstract

Accumulation of experiences and technological advances after the first report of laparoscopic liver resection (LLR) are now revealing the characteristics and specific advantages of this approach, especially for hepatocellular carcinoma (HCC) patients with chronic liver diseases (CLD). In laparoscopic approach, there are minimum needs for: (1) laparotomy and dissection of the attachments and adhesion which may cause destructions in the collateral blood and lymphatic flows; and (2) compression of the liver which may cause parenchymal damage for the liver resection (LR). These are especially beneficial for the patients with CLD. LLR results in minimal postoperative ascites and the other complications, which could potentially lead to lowering the risk of fatal liver failure. These characteristics of LLR facilitate surgical treatment application to the patients of HCC with background CLD. Laparoscopic approach also results in improved vision and manipulation in a small operative field under several conditions, including the cases where it is necessary to perform repeat LR between adhesions. These characteristics make LLR safer and more accessible to the repeat treatment, such as multicentric and metachronous lesions in the cirrhotic liver. These advantages of LLR indicate it is a superior method than open LR under certain conditions in patients of HCC with background CLD.

Keywords: Laparoscopic hepatectomy; Hepatocellular carcinoma; Liver cirrhosis; Chronic liver disease; Liver tumor; Liver resection; Repeat hepatectomy; Bridging therapy to transplantation; Ascites; Postoperative liver failure

Core tip: In laparoscopic approach, there are minimum needs for: (1) laparotomy and dissection of the attachments/adhesion which may cause destructions in the collateral blood/lymphatic flows; and (2) compression of the liver which may cause parenchymal damage for liver resection (LR). Therefore, laparoscopic LR (LLR) results in minimal postoperative ascites and following fatal complications in the patients with hepatocellular carcinoma and chronic liver disease. Laparoscopic approach also results in improved vision and manipulation in a small operative field in the case of repeat LR between adhesions. These characteristics make LLR safer and more accessible to the repeat treatment, such as multicentric/metachronous lesions in cirrhotic liver.