Laparoscopic liver resection for hepatocellular carcinoma: a three-year study of 57 Patients.

BACKGROUND/AIMS: Laparoscopic liver resection has become an increasingly popular operation but is still in relatively limited use. Here we evaluate the intermediate-term results of laparoscopic liver resection.

METHODOLOGY: Fifty-seven patients with HCC underwent laparoscopic liver resection at the Asan Medical Center. Data for all resections were recorded and analyzed retrospectively. Patient gender, age, preoperative laboratory data, presence of cirrhosis, blood loss, hospital stay length, pathology report, tumor site and size, resection type, resection margin, morbidity and mortality were assessed.

RESULTS: The mean patient age ranged from 35-74 years and the mean tumor size from 0.8-5.5 cm. Tumors were located in the left lateral lobe, left medial lobe and right lobe. Left lateral sectionectomy was performed in 32 cases, partial hepatectomy in 11, left hepatectomy in 6, right hepatectomy in 2, laparoscopy-assisted right hepatectomy in 2 and laparoscopy-assisted right posterior sectionectomy in 4. Median operation time ranged from 95-380 min while median blood loss ranged from 150-800 mL. The mean resection margin was 2.08±1.68 cm with no in-hospital mortalities. Return to normal diet was achieved on average at 1.83±0.8 days; mean hospital stay ranged from 3 to 17 days. The 3-year overall and disease-free survival rates were 81% and 71%, respectively.

CONCLUSIONS: Laparoscopic liver resection for HCC is feasible, safe and promising for a select group of patients. Its benefits include short hospital stays, rapid return to normal diet, full mobility and minimal morbidity with acceptable oncological parameters.