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Laparoscopic liver resection of hepatocellular carcinoma located in segments 7 or 8

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Abstract

Background

Many centers consider hepatocellular carcinoma (HCC) located in segments 7 or 8 to be unsuitable for laparoscopic liver resection (LLR). We evaluated the safety of LLR of HCC in segments 7 or 8 following the introduction of new laparoscopic techniques.

Methods

This retrospective study included 104 patients who underwent LLR (n = 46) or open liver resection (OLR) (n = 58) for HCC located in segments 7 or 8 between October 2004 and June 2015. The LLR group was subdivided into two subgroups according to whether LLR was performed before (Lap1; n = 29) or after (Lap2; n = 17) the introduction of the Pringle maneuver, intercostal trocars, and semi-lateral patient positioning.

Results

Non-anatomical resection was more frequent (63.0 vs. 29.3%; P < 0.001) and tumor size was smaller (2.8 vs. 4.7 cm; P < 0.001) in the LLR group than in the OLR group. Blood transfusion (P = 0.526), operation time (P = 0.267), postoperative complications (P = 0.051), and resection margin (P = 0.705) were similar in both groups. LLR was associated with less blood loss (550 vs. 700 ml, P = 0.030) and shorter hospital stay (8 vs. 10 days; P = 0.001). The 3-year overall (90.2 vs. 81.2%, P = 0.096) and disease-free survival (15.1 vs. 12.1%; P = 0.857) rates were similar in both groups. The Lap2 group has less blood loss (230 vs. 500 ml; P = 0.005) and shorter hospital stay (7 vs. 9 days; P = 0.038) compared with the Lap1 group.

Conclusion

LLR can be safely performed for HCC located in segments 7 or 8 with recent improvements in surgical techniques and accumulated experience.

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Authors and Affiliations

  1. Department of Surgery, Amai Pakpak Medical Center, Marawi, Philippines

    Hanisah Guro

  2. Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea

    Hanisah Guro, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Jae Seong Jang, Seong Uk Kwon, Sungho Kim & Jang Kyu Choi

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  1. Hanisah Guro
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Correspondence to Jai Young Cho.

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Disclosures

Drs. Hanisah Guro, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Jae Seong Jang, Seong, Uk Kwon, Sungho Kim and Jang Kyu Choi have no conflicts of interest or financial ties to disclose.

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Guro, H., Cho, J.Y., Han, HS. et al. Laparoscopic liver resection of hepatocellular carcinoma located in segments 7 or 8. Surg Endosc 32, 872–878 (2018). https://doi.org/10.1007/s00464-017-5756-x

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