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Kilburn et al. Hepatoma Res 2016;2:264-70 Hepatoma Research
DOI: 10.20517/2394-5079.2016.29
www.hrjournal.net
Topic: Advances in Minimally Invasive Cirrhotic Surgery Open Access

Laparoscopic resection of hepatocellular

carcinoma in patients with and without

cirrhosis: the Brisbane experience

Daniel J. Kilburn , Universe Leung , David J. Cavallucci , Cassandra Jeavons , Mehan Siriwardhane , Richard
1
1,2
1,3
1
1,3
Bryant , Thomas R. O’Rourke , Shinn Yeung , Nicholas A. O’Rourke 1,3
2
2
1
1 Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane and Women’s Hospital, Brisbane, Queensland 4029, Australia.
2 Hepatopancreatobiliary Unit, Department of Surgery, Princess Alexandra Hospital, Brisbane, Queensland 4102, Australia.
3 School of Medicine, The University of Queensland, Brisbane, Queensland 4072, Australia.
Correspondence to: Dr. Nicholas A. O’Rourke, Wesley Medical Centre Suite 47, 40 Chasely Street, Auchenflower, Brisbane, Queensland 4066,
Australia. E-mail: orourke.nick@gmail.com
How to cite this article: Kilburn DJ, Leung U, Cavallucci DJ, Jeavons C, Siriwardhane M, Bryant R, O’Rourke TR, Yeung S, O’Rourke NA.
Laparoscopic resection of hepatocellular carcinoma in patients with and without cirrhosis: the Brisbane experience. Hepatoma Res 2016;2:264-70.
Dr. Nicholas A. O’Rourke (Right) and Dr. Daniel J. Kilburn (Left) are co-authors of this paper. Dr. O’Rourke
is the Chairman of General Surgery and the Chief of HPB at the Royal Brisbane Hospital (RBH), Brisbane,
Queensland, Australia. He is an immediate past President of ANZHPBA and current Secretary-General
of the International Laparoscopic Liver Society (ILLS). Dr. Kilburn is a surgical resident at the RBH with a
keen interest in laparoscopic HPB surgery.

ABSTRACT
Article history: Aim: Laparoscopic liver resection for hepatocellular carcinoma (HCC) is increasingly
Received: 08-07-2016 common around the world. There may be significant advantages over open resections.
Accepted: 09-08-2016 However, due to technical difficulties, they are performed in few centers with expertise
Published: 30-09-2016 in liver and advanced laparoscopic surgery. In this study the authors summarize the
experience to date. Methods: A retrospective analysis of consecutive patients undergoing
Key words: laparoscopic liver resection for HCC in 2 tertiary academic hepatobiliary units in Brisbane,
Hepatocellular carcinoma, Australia, between 1999 and 2015 was performed. Operative characteristics, perioperative
hepatoma, morbidity, and pathological data were described. Patients with and without cirrhosis were
hepatectomy, analyzed and compared. Results: Fifty-two patients underwent resection of 79 HCCs.
laparoscopic surgery, Sixty-five percent of patients had cirrhosis. Fourteen percent of patients underwent a major
liver cirrhosis hepatectomy. There was a trend towards more parenchyma-sparing resections for cirrhotic
patients. Blood loss was higher in cirrhotics. Conversion to an open procedure occurred
in 9%. There was one 90-day mortality due to liver failure (1.9%), and 7 patients (13%)
experienced a complication. R0 resection was achieved in 92%. Overall survival at 1, 3, and
5 years was 88%, 81%, and 61%, respectively. Conclusion: Laparoscopic liver resection for
HCC, particularly in cirrhotic patients, is technically challenging. It can be performed with
acceptable morbidity and adequate surgical margins.

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