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Otsuka et al. Hepatoma Res 2021;7:5 Hepatoma Research
DOI: 10.20517/2394-5079.2020.112

Original Article Open Access

Feasibility of totally laparoscopic hemi-
hepatectomies for liver tumor, with consideration of

correspondence for difficult cases

Yuichiro Otsuka, Yuko Ito, Yu Matsumoto, Kazutaka Kimura, Yoji Kajiwara, Kazunori Okubo, Masaru
Tsuchiya, Rei Okada, Jun Ishii, Tetsuya Maeda, Kimihiko Funahashi, Hironori Kaneko

Division of General and Gastroenterological Surgery (Omori), Department of Surgery, Toho University Faculty of Medicine,
Tokyo 143-8541, Japan.

Correspondence to: Prof. Yuichiro Otsuka, Division of General and Gastroenterological Surgery (Omori), Department of Surgery,
Toho University Faculty of Medicine, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan. E-mail: yotsuka@med.toho-u.ac

How to cite this article: Otsuka Y, Ito Y, Matsumoto Y, Kimura K, Kajiwara Y, Okubo K, Tsuchiya M, Okada R, Ishii J, Maeda
T, Funahashi K, Kaneko H. Feasibility of totally laparoscopic hemi-hepatectomies for liver tumor, with consideration of
correspondence for difficult cases. Hepatoma Res 2021;7:5. http://dx.doi.org/10.20517/2394-5079.2020.112
Received: 24 Sep 2020 First Decision: 18 Nov 2020 Revised: 26 Nov 2020 Accepted: 14 Dec 2020 Published: 7 Jan 2021

Academic Editor: Ho-Seong Han, Luca Aldrighetti Copy Editor: Miao Zhang Production Editor: Jing Yu
Received: First Decision: Revised: Accepted: Published:

Science Editor: Copy Editor: Production Editor: Jing Yu Abstract
Aim: Laparoscopic liver resection (LLR) has been recognized as a minimally invasive surgery offering disease
curability for liver tumors. Moreover, recent publications suggest that the systematic liver resections including
hemi-hepatectomies have been performed safely in high volume centers. We describe our indication, standardized
technique, and surgical outcome for totally laparoscopic hemi-hepatectomy (TLHH). Moreover, we hypothesize
that TLHHs can be performed feasibly, as well as discuss the technical correspondence of technically difficult
cases which have marginal indication for TLHHs.

Methods: From September 2008 to July 2020, in total, 488 cases of liver resections including 222 cases of LLR
were performed in our institution. We invented the favorable indication of TLHHs of locally resectable tumors
without involvement of tumor to hepatic hilus, confluence of hepatic veins, inferior vena cava, or extrahepatic
organs, in patients with sufficient hepatic functional reserve for hemi-hepatectomies. Among 21 TLHHs for liver
tumors performed during study period, there were cases which derogate favorable indications; however, they
might have been able to undergo TLHHs. We divided these cases into “difficult indication group (DIG)” (10 of 21
cases) and “favorable indication group (FIG)”; compared them on perioperative background, surgical outcome;
and discussed the technical correspondence of TLHHs on DIG.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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