한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제15권1호
  • /
  • Pages.7-12
  • /
  • 2011
  • /
  • 2508-5778(pISSN)
  • /
  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지

Preliminary Experience of Laparoscopic Hepatectomy for Hepatocellular Carcinoma

  • Lee, Gwan Chul (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, Choon Hyuck David (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Joh, Jae Won (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Heo, Jin Seok (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jung, Gum O. (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Moon, Ju Ik (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Jong Man (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Mill Jae (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Moon Suk (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2011.02.28
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Laparoscopic liver resection has gained much popularity in recent years, but relatively few centers have performed hepatectomies in hepatocellular carcinoma (HCC) patients due to the technical difficulties faced with underlying liver cirrhosis. We now present our early experience with laparoscopic liver resection in HCC performed in a single institution. Methods: From October 2003 until March 2009, 39 laparoscopic liver resections were performed on HCC patients among whom 26 had underlying liver cirrhosis. Results: The location of the tumor was in the left lateral section in 15, segment 5 or 6 in 20, segment 4 in 3 and caudate lobe in 1. Resection involving less than a monosegment was done in 26 and more than 2 segments in 13. Tumor size ranged from 0.8 cm to 6.6 cm (median 2.35) and the resection margin from 0.1 to 6 cm (median 1.5 cm). All patients were either stage I (29) or II (10). There was no difference between cirrhotic and non-cirrhotic patients in operation time (median 210 minutes, range 60~637), change of hematocrit value (4.8%, -1~19.6%), or hospital stay (8 days, 3~67 days). The median follow up duration was 15.1 months, and the 2-year recurrence free survival rate was 48.3%. Conclusion: Laparoscopic liver resection in HCC with or without underlying cirrhosis seems to be feasible with minimal morbidity, especially in well selected cases with early stage HCC.

키워드

참고문헌

  1. Gagner M, Rogula T, Selzer D. Laparoscopic liver resection: benefits and controversies. Surg Clin North Am 2004;84: 451-462. https://doi.org/10.1016/j.suc.2003.11.002
  2. Pulitano C, Aldrighetti L. The current role of laparoscopic liver resection for the treatment of liver tumors. Nat Clin Pract Gastroenterol Hepatol 2008;5:648-654. https://doi.org/10.1038/ncpgasthep1253
  3. Pilgrim CH, To H, Usatoff V, Evans PM. Laparoscopic hepatectomy is a safe procedure for cancer patients. HPB (Oxford) 2009;11:247-251. https://doi.org/10.1111/j.1477-2574.2009.00045.x
  4. Simillis C, Constantinides VA, Tekkis PP, et al. Laparoscopic versus open hepatic resections for benign and malignant neoplasms--a meta-analysis. Surgery 2007;141:203-211. https://doi.org/10.1016/j.surg.2006.06.035
  5. McPhail MJ, Scibelli T, Abdelaziz M, Titi A, Pearce NW, Abu Hilal M. Laparoscopic versus open left lateral hepatectomy. Expert Rev Gastroenterol Hepatol 2009;3:345-351. https://doi.org/10.1586/egh.09.36
  6. Rowe AJ, Meneghetti AT, Schumacher PA, et al. Perioperative analysis of laparoscopic versus open liver resection. Surg Endosc 2009;23:1198-1203. https://doi.org/10.1007/s00464-009-0372-z
  7. Ryu HR, Park JS, Hwang HK, et al. Initial experience with laparoscopic and DaVinci Robotic-assisted liver resection. Korean J Hepatobiliary Pancreat Surg 2008;12:254-257.
  8. Laurent A, Cherqui D, Lesurtel M, Brunetti F, Tayar C, Fagniez PL. Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg 2003;138:763-769. https://doi.org/10.1001/archsurg.138.7.763
  9. Rau HG, Buttler E, Meyer G, Schardey HM, Schildberg FW. Laparoscopic liver resection compared with conventional partial hepatectomy--a prospective analysis. Hepatogastroenterology 1998;45:2333-2338.
  10. Lai EC, Tang CN, Ha JP, Li MK. Laparoscopic liver resection for hepatocellular carcinoma: ten-year experience in a single center. Arch Surg 2009;144:143-147. https://doi.org/10.1001/archsurg.2008.536
  11. Dagher I, Di Giuro G, Dubrez J, Lainas P, Smadja C, Franco D. Laparoscopic versus open right hepatectomy: a comparative study. Am J Surg 2009;198:173-177. https://doi.org/10.1016/j.amjsurg.2008.09.015
  12. Gigot JF, Hubert C, Banice R, Kendrick ML. Laparoscopic management of benign liver diseases: where are we? HPB (Oxford) 2004;6:197-212. https://doi.org/10.1080/13651820410023950
  13. Descottes B, Glineur D, Lachachi F, et al. Laparoscopic liver resection of benign liver tumors. Surg Endosc 2003;17:23-30. https://doi.org/10.1007/s00464-002-9047-8
  14. Soubrane O, Cherqui D, Scatton O, et al. Laparoscopic left lateral sectionectomy in living donors: safety and reproducibility of the technique in a single center. Ann Surg 2006;244: 815-820. https://doi.org/10.1097/01.sla.0000218059.31231.b6
  15. Kaneko H, Takagi S, Otsuka Y, et al. Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg 2005;189: 190-194. https://doi.org/10.1016/j.amjsurg.2004.09.010
  16. Chen HY, Juan CC, Ker CG. Laparoscopic liver surgery for patients with hepatocellular carcinoma. Ann Surg Oncol 2008;15:800-806. https://doi.org/10.1245/s10434-007-9749-1
  17. Lai EC, Tang CN, Yang GP, Li MK. Minimally invasive surgical treatment of hepatocellular carcinoma: long-term outcome. World J Surg 2009;33:2150-2154. https://doi.org/10.1007/s00268-009-0155-7
  18. Abdel-Atty MY, Farges O, Jagot P, Belghiti J. Laparoscopy extends the indications for liver resection in patients with cirrhosis. Br J Surg 1999;86:1397-1400. https://doi.org/10.1046/j.1365-2168.1999.01283.x