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Igarashi et al. Hepatoma Res 2022;8:21 Hepatoma Research
DOI: 10.20517/2394-5079.2022.02

Case Report Open Access

Repeat laparoscopic anatomical liver resection in a

hepatocellular carcinoma patient: a case report

1
1
1,2
Kazuharu Igarashi , Kohei Mishima , Takahiro Ozaki , Go Wakabayashi 1
1
Department of Surgery, Ageo Central General Hospital, Ageo, Saitama 362-8588, Japan.
2
Department of General-Pediatric Hepatobiliary Pancreatic Surgery, Kitasato University School of Medicine, Sagamihara,
Kanagawa 252-0374, Japan.
Correspondence to: Go Wakabayashi, MD, PhD, Department of Surgery, Ageo Central General Hospital, Kashiwaza 1-10-10,
Ageo, Saitama 362-8588, Japan. E-mail: gowaka@ach.or.jp
How to cite this article: Igarashi K, Mishima K, Ozaki T, Wakabayashi G. Repeat laparoscopic anatomical liver resection in a
hepatocellular carcinoma patient: a case report. Hepatoma Res 2022;8:21. https://dx.doi.org/10.20517/2394-5079.2022.02
Received: 26 Jan 2022 First Decision: 9 Mar 2022 Revised: 21 Mar 2022 Accepted: 2 Apr 2022 Published: 24 Apr 2022

Academic Editor: Salvatore Gruttadauria Copy Editor: Tiantian Shi Production Editor: Tiantian Shi

Abstract
Anatomical resection (AR) has been reported to achieve better long-term outcomes than non-anatomical resection
for the treatment of hepatocellular carcinoma (HCC). The surgical feasibility and oncological significance of
laparoscopic AR (LAR), especially “subsegment resection”, “cone unit resection”, and repeat LAR for HCC, remain
unproven. We present a 67-year-old patient with alcoholic liver cirrhosis and HCC who underwent full LAR three
times, focusing on the technical aspects of the Glissonean approach. Repeating LAR for recurrent HCC could be a
safe and feasible procedure. However, HCC recurred in the neighboring segment twice, even though pathological
vascular invasion and marginal remnants were not confirmed. We should investigate the oncological significance
and advancements in subsegmentectomy and cone unit resection, in the future.
Keywords: Repeat laparoscopic anatomical liver resection, HCC, Glissonean approach, subsegmentectomy, cone
unit resection

INTRODUCTION
Anatomical resection (AR) has been reported to achieve better long-term outcomes than non-anatomical
resection for the treatment of hepatocellular carcinoma (HCC) . Laparoscopic liver resection (LLR) has
[1,2]
[3-7]
recently gained popularity because of its short-term advantages compared with open liver resection .
However, the surgical feasibility and oncological significance of laparoscopic AR (LAR), especially

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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