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Morise et al. Hepatoma Res 2016;2:253-8 Hepatoma Research
DOI: 10.20517/2394-5079.2016.09
www.hrjournal.net
Topic: Advances in Minimally Invasive Cirrhotic Surgery Open Access

Case report of the fourth laparoscopic liver

resection and review of repeat laparoscopic

resection for recurrent hepatocellular

carcinoma in cirrhotic liver

Zenichi Morise , Masashi Isetani , Norihiko Kawabe , Hirokazu Tomishige , Hidetoshi Nagata , Satoshi Arakawa ,
1
2
2
2
2
2
Masahiro Ikeda , Kenshiro Kamio 2
2
1 Department of Surgery, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan.
2 Department of Surgery, Fujita Health University Banbuntane Houtokukai Hospital, Nagoya, Aichi 454-8509, Japan.
Correspondence to: Prof. Zenichi Morise, Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo
Kutsukakecho, Toyoake, Aichi 470-1192, Japan. E-mail: zmorise@fujita-hu.ac.jp
How to cite this article: Morise Z, Isetani M, Kawabe N, Tomishige H, Nagata H, Arakawa S, Ikeda M, Kamio K. Case report of the fourth laparoscopic
liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver. Hepatoma Res 2016;2:253-8.
Prof. Zenichi Morise graduated from Keio University and got his M.D. in 1987, and obtained Ph.D. in
Medicine in the same university in 1995. He was post-doctoral research fellow of Louisiana State University
Medical Center between 1995 and 1998. He has been professor in the Department of Surgery, Fujita Health
University School of Medicine since 2010. He is certified from Japanese Board of Cancer Therapy, Japanese
Surgical Society, Japanese Society of Gastroenterological Surgery, Japanese Society of Hepato-Biliary-
Pancreatic Surgery and Japanese Society for Surgical Metabolism and Nutrition. Besides, he is editorial
board member of World Journal of Gastrointestinal Surgery, World Journal of Gastroenterology, Frontiers in
Surgery, Hepatoma Research, and Fujita Medical Journal. He is also member of American College of
Surgeons, American Gastroenterological Association, Society for Surgery of the Alimentary Tract (USA),
International Society of Surgery, International Society of Digestive Surgery, International Hepato-Pancreato-
Biliary Association, etc.

ABSTRACT
Article history: A 73-year-old woman with liver cirrhosis caused by hepatitis C virus (HCV) underwent
Received: 06-04-2016 treatment of three hepatocellular carcinomas (HCCs) in liver segment 4, following three
Accepted: 15-07-2016 previous laparoscopic liver resections (LLRs) over 73 months. Contrast-enhanced computed
Published: 19-09-2016 tomography showed three 0.5-1.2 cm HCCs deep within the portal territories of subsegments
4a and 4b. The patient underwent laparoscopic resection of 4a and 4b, with the preservation
of the portal branch to 4c, after minimal adhesiolysis around segment 4. The operation lasted
Key words: 284 min, there was 50 mL of intra-operative bleeding and her recovery was uneventful.
Laparoscopic liver resection, She was well, had experienced no recurrence and was HCV-negative, after taking oral anti-
repeat liver resection, HCV therapy, 21 months later. LLR is associated with fewer adhesions after surgery and
hepatocellular carcinoma, requires less adhesiolysis, because the laparoscope and forceps can be used in the small
liver cirrhosis, spaces between adhesions. The present patient underwent four LLRs over 6 years without
anatomical liver resection, severe deterioration of liver functional reserve. LLR is a useful localized therapy, which
subsegmentectomy can be performed repeatedly and may prolong the survival of patients with multicentric
metachronous HCCs.
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