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Otsuka et al. Hepatoma Res 2016;2:241-7 Hepatoma Research
DOI: 10.20517/2394-5079.2016.11
www.hrjournal.net
Topic: Advances in Minimally Invasive Cirrhotic Surgery Open Access

Indications and technique for laparoscopic

liver resection in patients with hepatocellular

carcinoma and liver cirrhosis

Yuichiro Otsuka, Masaru Tsuchiya, Toshio Katagiri, Yoshihisa Kubota, Jun Ishii, Tetsuya Maeda, Hironori Kaneko

Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo 143-8541, Japan.
Correspondence to: Dr. Hironori Kaneko, Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty
of Medicine, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan. E-mail: hironori@med.toho-u.ac.jp

How to cite this article: Otsuka Y, Tsuchiya M, Katagiri T, Kubota Y, Ishii J, Maeda T, Kaneko H. Indications and technique for laparoscopic liver
resection in patients with hepatocellular carcinoma and liver cirrhosis. Hepatoma Res 2016;2:241-7.

ABSTRACT
Article history: Liver resection is the preferred initial treatment option for solitary or limited multifocal
Received: 26-04-2016 hepatocellular carcinoma (HCC). However, because of the characteristics of HCC, including its
Accepted: 12-07-2016 high recurrence rate and the frequent presence of chronic hepatitis and cirrhosis, both curability and
Published: 19-09-2016 invasiveness must be considered when selecting a treatment for HCC. Laparoscopic liver resection
(LLR) is minimally invasive and increasingly performed worldwide as a curative surgical option
for treatment of liver tumors. The 2014 International Consensus Conference on LLR concluded
Key words: that minor LLRs are now standard practice. Meta-analyses suggest that, as compared with open
Laparoscopic liver resection, hepatectomy, LLR for patients with HCC, including those with cirrhosis, resulted in less blood loss,
hepatocellular carcinoma, lower postoperative hospitalization rates, and similar oncological outcomes. Although candidates
liver cirrhosis for this procedure should be carefully evaluated, LLR appears to be a feasible option for treatment
of HCC with liver cirrhosis. This review describes the indications for LLR in this patient subgroup
and offers guidance on appropriate surgical technique.

INTRODUCTION spread. [2-6] The mortality and morbidity of liver resection
have significantly decreased in the last two decades
Hepatocellular carcinoma (HCC) is the sixth most because of improvements in patient evaluation, surgical
common neoplasm and the third most frequent cause technique, and perioperative care. Resection is the
of cancer death in the world. Because of the specific ideal treatment, as it allows for complete removal and
[1]
characteristics of HCC, including its high recurrence pathological confirmation of lesions. However, it is more
rate and the frequent presence of chronic hepatitis and invasive than other locoregional therapies such as
cirrhosis, HCC treatment should focus on both curability transarterial chemoembolization, tumor ablative therapy,
and invasiveness. and radiation therapy. [7-10]

Liver resection is the preferable initial treatment option for Laparoscopy has been used extensively and continues to
solitary or limited multifocal HCCs with no extrahepatic improve as a surgical option. Laparoscopic liver resection

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