Laparoscopic hepatic resection for hepatocellular carcinoma - Retrospective study of 12 patients

Aims - To assess the results of laparoscopic liver resection for hepatocellular carcinoma. Patients and methods - From 1998 to 2003, 12 laparoscopic liver resections for hepatocellular carcinoma were performed. Results - There were no operative complications and no deaths. Conversion to laparotomy was required in one patient (8%) and transfusion in three patients (25%). One patient died of liver failure. Postoperative complications occurred in three patients (25%): trocar site bleeding, cardiac failure and biliary collection. The mean hospital stay was 5 days. No ascites and no transient liver failure occurred. During the mean follow up of 15 months the recurrence rate was 45.5%. No port site or peritoneal metastases were observed. Treatment of recurrence was second resection in two patients and microwave coagulation therapy in two other patients. Mean survival was 24 months. Conclusion - Laparoscopic liver resection is feasible in hepatocellular carcinoma if the tumor is unique, smaller than 5 centimeters and located in the left lateral segments or in the anterior or inferior segments of the right liver. Postoperative morbidity is low and longterm results seem to be similar to laparotomy.