Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

Truant, Stéphanie; Bouras, Ahmed Fouad; Hebbar, Mohamed; Boleslawski, Emmanuel; Fromont, G.; Dharancy, Sébastien; Leteurtre, Emmanuelle; Zerbib, Philippe; Pruvot, François‐René

doi:10.1007/s00464-011-1775-1

Cited by 116 publications

(69 citation statements)

References 45 publications

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“…The safety and feasibility of the laparoscopic approach and its short-term benefits for HCC patients with chronic liver dysfunction have been demonstrated by several series [21][22][23][24][25][26][27][28][29][30][31] . To date, several studies have investigated the major differences between laparoscopic hepatectomy and open hepatectomy (Tables 1 and 2) [32][33][34][35][36][37][38][39] . Favorable short-term results, including fewer incidences of ascites and liver failure, and shorter postoperative hospital stays, correlate with the laparoscopic procedure.…”

Section: Laparoscopic Hepatectomy For Hcc Patients: An Overviewmentioning

confidence: 99%

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Morise¹,

Kawabe

Kawase

et al. 2013

WJH

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Pure laparoscopic hepatectomy is a less invasive procedure than conventional open hepatectomy for the resection of hepatic lesions. Increases in experiences with the technique, in combination with advances in technology, have promoted the popularity of pure laparoscopic hepatectomy. However, indications for usage and potential contraindications of the procedure remain unresolved. The characteristics and specific advantages of the procedure, especially for hepatocellular carcinoma (HCC) patients with chronic liver diseases, are reviewed and discussed in this paper. For cirrhotic patients with liver tumors, pure laparoscopic hepatectomy minimizes destruction of the collateral blood and lymphatic flow from laparotomy and mobilization, and mesenchymal injury from compression. Therefore, pure laparoscopic hepatectomy has the specific advantage of minimal postoperative ascites production that leads to lowering the risk of disturbance in water or electrolyte balance and hypoproteinemia. It minimizes complications that routinely trigger postoperative serious liver failure. Under adequate patient positioning and port arrangement, the partial resection of the liver in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated in pure laparoscopic surgery by providing good vision and manipulation in the small operative field. Furthermore, the features of reduced post-operative adhesion, good vision, and manipulation within the small area between the adhesions make this procedure safer in the context of repeat hepatectomy procedures. These improved features are especially advantageous for patients with liver cirrhosis and multicentric and/or metachronous HCCs. Key words: 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: 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.

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Section: Laparoscopic Hepatectomy For Hcc Patients: An Overviewmentioning

confidence: 99%

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Morise¹,

Kawabe

Kawase

et al. 2013

WJH

View full text Add to dashboard Cite

show abstract

“…The long-term effect is the major controversy on laparoscopic liver resection for liver malignancies and many retrospective or casematched studies had been carried out (36)(37)(38)(39)(40)(41)(42). According to current experience, there is no difference of survival time between laparoscopic liver resection and open liver resection, but the final conclusion should base on data from multi-center and randomized case-controlled clinical trials.…”

Section: Outcomes Of Laparoscopic Liver Resectionmentioning

confidence: 99%

Laparoscopic liver resection: the current status and the future

Cai

2018

Hepatobiliary Surg. Nutr.

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“…The appropriate treatment modality selection is dependent not only on tumor stage but also on the severity of the underlying liver disease [20]. Actually, several published literatures have supported the safety of laparoscopic liver resection in patients with cirrhosis [3,10,11,21,22]. However, these studies were limited to either minor resections or easily accessible lesion locations.…”

Section: Discussionmentioning

confidence: 99%

“…With the improvement in laparoscopic instruments and growing experience in laparoscopic and liver surgery, more studies with favorable results in laparoscopic liver resection as to the open method, such as the short-term outcomes of reduced surgical stress and blood loss, comparable or decreased postoperative morbidity and mortality, shorter operative duration, and hospital stay, as well as the good oncological long-term outcomes, have been reported [5,11,18,19]. Therefore, in a complex clinical condition like the presence of liver cirrhosis, laparoscopic liver resection is expected to be more beneficial.…”

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of a Laparoscopy-Assisted Non-Anatomic Resection Technique for Hepatocellular Carcinoma Located at Right Posterior Segments in Cirrhotic Patients: A Case-Controlled Study with Propensity Score Matching

et al. 2017

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Purpose: The aim of this study was to compare the short- and long-term outcomes of laparoscopy-assisted resection for right posterior segment (LAR-RPS) with open resection (OR-RPS) performed by experienced hepatobiliary surgeons. Methods: This was a prospective comparative nonrandomized study. Results: The groups were comparable in terms of baseline demographics and clinicopathological data. Reduced operative time (254.88 ± 78.56 vs. 347.95 ± 82.56 min; p = 0.04) and estimated blood loss (477 ± 756 vs. 712 ± 836 mL; p = 0.03) were observed in LAR-RPS. Also, signiﬁcant less duration of hospital stay (7.53 ± 2.68 vs. 12.57 ± 3.21 days; p < 0.001) was associated with LAR-RPS compared to OR-RPS. Long-term oncologic outcomes were comparable in 2 groups, in terms of both the overall and disease-free survival rates (p = 0.450 and 0.463, respectively). Conclusions: This study confirms that laparoscopic-assisted resection is a safe and effective operative procedure in those cirrhotic patients with a lesion in the right posterior section of the liver. When compared to the open approach, the laparoscopic-assisted approach reduces operative time and blood loss, as well as the length of hospital stay.

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Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

Abstract: Laparoscopic resection of HCC in patients with chronic liver disease has similar results to open resection in terms of postoperative outcomes, surgical margins, and long-term survival.

Cited by 116 publications

References 45 publications

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Laparoscopic liver resection: the current status and the future

Safety and Feasibility of a Laparoscopy-Assisted Non-Anatomic Resection Technique for Hepatocellular Carcinoma Located at Right Posterior Segments in Cirrhotic Patients: A Case-Controlled Study with Propensity Score Matching

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