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Giacca et al. Hepatoma Res 2018;4:47 Hepatoma Research
DOI: 10.20517/2394-5079.2018.79

Review Open Access

Laparoscopic liver resection for hepatocellular
carcinoma

Massimo Giacca, Daniel Cherqui

Hepatobiliary Center, Paul Brousse Hospital-Assistance Publique-Hopitaux de Paris, Universite’ Paris Sud, Villejuif 94800,
France.

Correspondence to: Dr. Massimo Giacca, Hepatobiliary Center, Paul Brousse Hospital-Assistance Publique-Hopitaux de Paris,
Universite’ Paris Sud, Villejuif 94800, France. E-mail: massimogiacca4@gmail.com
How to cite this article: Giacca M, Cherqui D. Laparoscopic liver resection for hepatocellular carcinoma. Hepatoma Res 2018;4:47.
http://dx.doi.org/10.20517/2394-5079.2018.79
Received: 16 Jun 2018 First Decision: 9 Jul 2018 Revised: 18 Jul 2018 Accepted: 22 Jul 2018 Published: 17 Aug 2018

Science Editor: Guang-Wen Cao Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Hepatocellular carcinoma (HCC) represents the most common indication of laparoscopic liver resection (LLR). It must
be acknowledged that most series concern minor hepatectomies for peripheral lesions located in favorable segments,
and such procedures are now performed in the majority of HPB centers. However, there are growing reports concerning
major hepatectomies (i.e., 3 segments or more) and complex resections such as anatomical resections in difficult
segments (i.e., postero-superior). Retrospective comparative studies, including some with propensity score matching,
and meta-analyses showed that LLR is associated with short-term benefits including reduced blood loss, length of stay
and morbidity with identical oncological results and survival rates. In addition, laparoscopy leads to less post-operative
abdominal adhesions, improving operative outcomes in case of repeat hepatectomy or secondary liver transplantation.
Despite the lack of results of randomized-controlled trials in HCC, a consensus exists that the laparoscopic approach
can improve the outcome of major liver resections, provided it is performed in experienced centers. This requires
specific high-quality training.

Keywords: Laparoscopy, hepatocellular carcinoma, cirrhosis, hepatectomy, liver resection

INTRODUCTION
Since 2000, when the first case-series was published , laparoscopic liver resection (LLR) has represented a
[1]
growing challenge. The number of resections and the extension to major hepatectomies and difficult locations
have increased worldwide over the last 10 years. In contrast with other procedures, liver resections address

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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