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Morise. Hepatoma Res 2020;6:79 Hepatoma Research
DOI: 10.20517/2394-5079.2020.76

Review Open Access

Current status of laparoscopic repeat liver resection
for hepatocellular carcinoma

Zenichi Morise

Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, Okazaki AICHI 444-0827, Japan.
Correspondence to: Prof. Zenichi Morise, Department of Surgery, Fujita Health University School of Medicine Okazaki Medical
Center, Gotanda Harisakicho Okazaki, Okazaki AICHI 444-0827, Japan. E-mail: zmorise@fujita-hu.ac.jp

How to cite this article: Morise Z. Current status of laparoscopic repeat liver resection for hepatocellular carcinoma. Hepatoma
Res 2020;6:79. http://dx.doi.org/10.20517/2394-5079.2020.76

Received: 4 Aug 2020 First Decision: 4 Sep 2020 Revised: 12 Sep 2020 Accepted: 21 Sep 2020 Published: 6 Nov 2020

Academic Editor: Ho-Seong Han Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Although liver resection (LR) is often adopted to recurrent hepatocellular carcinomas, risks of complications and
conversion reportedly increase in laparoscopic repeat LR (LRLR). The indication is not agreed upon even with the
Received: First Decision: Revised: Accepted: Published:
recent advances of laparoscopic LR. We conducted an international propensity score matching study of LRLR
Science Editor: Copy Editor: Production Editor: Jing Yu and open repeat LR for hepatocellular carcinoma with 1,582 patients from 42 world centers. Propensity-score
matched LRLR patients have smaller blood loss and longer operation time than open repeat LR patients. Median
overall survival time was 8.94 years in open and 12.55 years in LRLR; although the difference was not significant,
the P-value was 0.0855 and the better curve of LRLR is clearly separated from that of open. In our institution, we
experienced 34 LRLR and 12 cases of three times or more repeat LR until 2019. There are no significant differences
in operation time, blood loss, hospital stay, conversion, and morbidity rates among first, second, and third or higher
laparoscopic LR, which is different from the open situation. However, postoperative bile leakage and intraoperative
bleeding causing conversion did happen in the cases with repeat extended exposure of Glissonian pedicle. LRLR
is feasible for selected patients. However, the procedure is under developing stage and further accumulation of
experiences and evaluation are needed.

Keywords: Laparoscopic liver resection, hepatocellular carcinoma, re-do surgery

INTRODUCTION
Hepatocellular carcinoma (HCC) can occur in multifocal and metachronous style with the neoplastic
[1,2]
background with chronic liver diseases. Repeat liver resection (LR) is often required for the condition .
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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