Laparoscopic liver resection for hepatocellular carcinoma in patients with cirrhosis

Abstract

Hepatocellular carcinoma (HCC) is a common malignant tumor and many cases occur in patients with liver cirrhosis. Although liver transplantation is the most effective treatment option, hepatectomy is still the first curative treatment option because liver transplantation is limited by the donors and high cost. In recent years, laparoscopic liver resection (LLR) has increasingly been performed in patients with liver cirrhosis, and has several advantages over open liver resection. Besides less pain and shorter hospital stay, LLR in patients with liver cirrhosis is also associated with lower incidences of postoperative liver failure and ascites because of greater preservation of collateral veins and less liver manipulation. With increasing experience, LLR for HCC located in segments 7 or 8 is now feasible, and anatomic LLR could be performed in patients with cirrhosis. Many comparative studies have shown that LLR is better than open liver resection in patients with liver cirrhosis in terms of a lower incidence of postoperative liver failure and similar patient survival. In conclusion, LLR is a promising treatment modality for HCC in patients with liver cirrhosis.

Keywords

Laparoscopy / hepatectomy / cirrhosis / portal hypertension

References

[1] El-Serag HB.Hepatocellular carcinoma: epidemiology and molecular carcinogenesis..Gastroenterology2007;132:2557-76

[2] Llovet JM.Novel advancements in the management of hepatocellular carcinoma in 2008..J Hepatol2008;48 Suppl 1:S20-37

[3] Fattovich G,Zagni I.Hepatocellular carcinoma in cirrhosis: incidence and risk factors..Gastroenterology2004;127 Suppl 1:S35-50

[4] Kao JH.Risk stratification of HBV infection in Asia-Pacific region..Clin Mol Hepatol2014;20:223-7 PMCID:PMC4197169

[5] Poon D,Chen LT,Lau WY,Singh H,Ooi LL,Khin MW,Asian Oncology Summit.Management of hepatocellular carcinoma in Asia: consensus statement from the Asian Oncology Summit 2009..Lancet Oncol2009;10:1111-8

[6] Bruix J,Llovet JM,Lencioni R,Christensen E,Colombo M.Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver..J Hepatol2001;35:421-30

[7] Bruix J,Sherman M.Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma..Gastroenterology2016;150:835-53

[8] Fan ST,Liu CL,Yuen WK,Wong J.Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths..Ann Surg1999;229:322-30 PMCID:PMC1191696

[9] Jaskille A,Park K,Wang D.Abdominal insufflation decreases blood loss and mortality after porcine liver injury..J Trauma2005;59:1305-8

[10] Poon RT,Lo CM,Liu CL,Wong J.Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years..Ann Surg2001;234:63-70 PMCID:PMC1421949

[11] Belghiti J,Durand F,Dondero F,Sauvanet A,Degos F.Resection of hepatocellular carcinoma: a European experience on 328 cases..Hepatogastroenterology2002;49:41-6

[12] Gaillard M,Dagher I.Laparoscopic liver resections for hepatocellular carcinoma: current role and limitations..World J Gastroenterol2014;20:4892-9 PMCID:PMC4009520

[13] Shehta A,Yoon YS,Choi Y.Laparoscopic liver resection for hepatocellular carcinoma in cirrhotic patients: 10-year single-center experience..Surg Endosc2016;30:638-48

[14] Han HS,Cho JY.Laparoscopic liver resection for hepatocellular carcinoma: korean experiences..Liver Cancer2013;2:25-30 PMCID:PMC3747549

[15] Tzanis D,Laurent A,Soubrane O,Ettore GM,Lainas P,Edwin B,Campos RR,Gayet B.European experience of laparoscopic major hepatectomy..J Hepatobiliary Pancreat Sci2013;20:120-4

[16] Ettorre GM,Santoro R,Lepiane P,Felli E,Colace L,Montalbano M,Maritti M,Santoro E.Laparoscopic liver resection for hepatocellular carcinoma in cirrhotic patients: single center experience of 90 cases..Hepatobiliary Surg Nutr2015;4:320-4

[17] Koffron A,Gamblin TC.Laparoscopic liver surgery: shifting the management of liver tumors..Hepatology2006;44:1694-700

[18] Buell JF,Doty TC,Merchen TD,Rudich SM.An initial experience and evolution of laparoscopic hepatic resectional surgery..Surgery2004;136:804-11

[19] Cherqui D,Hammoud R,Stéphan F,Rotman N.Laparoscopic liver resections: a feasibility study in 30 patients..Ann Surg2000;232:753-62 PMCID:PMC1421268

[20] Muangkaew P,Han HS,Choi Y,Choi H,Kwon SU.Defining surgical difficulty according to the perceived complexity of liver resection: validation of a complexity classification in patients with hepatocellular carcinoma..Ann Surg Oncol2016;23:2602-9

[21] Lee MK4th,Strasberg SM.Perceived complexity of various liver resections: results of a survey of experts with development of a complexity score and classification..J Am Coll Surg2015;220:64-9 PMCID:PMC4896395

[22] Lee MK4th,Strasberg SM.Completion of a liver surgery complexity score and classification based on an international survey of experts..J Am Coll Surg2016;223:332-42 PMCID:PMC5561649

[23] Cho JY,Yoon YS.Feasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location..Surgery2008;144:32-8

[24] Dagher I,Carloni A,Tranchart H.Laparoscopic liver resection: results for 70 patients..Surg Endosc2007;21:619-24

[25] Xiao L,Li JW,Fan YD.Laparoscopic versus open liver resection for hepatocellular carcinoma in posterosuperior segments..Surg Endosc2015;29:2994-3001

[26] Soubrane O,Laurent A,Truant S,Salloum C,Dokmak S,Cherqui D,Boleslawski E,Sa Cunha A,Pessaux P,Scatton O.Laparoscopic resection of hepatocellular carcinoma: a French survey in 351 patients..HPB (Oxford)2014;16:357-65 PMCID:PMC3967888

[27] Dagher I,Fantini C,Tayar C,Tranchart H,Cherqui D.Laparoscopic hepatectomy for hepatocellular carcinoma: a European experience..J Am Coll Surg2010;211:16-23

[28] Farges O,Flejou JF,Sauvanet A.Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal..Ann Surg1999;229:210-5 PMCID:PMC1191633

[29] Cucchetti A,Vivarelli M,Ravaioli M,Zanello M,Pinna AD.Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis..Liver Transpl2006;12:966-71

[30] Malinchoc M,Gordon FD,Rank J.A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts..Hepatology2000;31:864-71

[31] Kamath PS,Malinchoc M,Therneau TM,D'Amico G,Kim WR.A model to predict survival in patients with end-stage liver disease..Hepatology2001;33:464-70

[32] Delis SG,Dervenis C.Perioperative risk assessment for hepatocellular carcinoma by using the MELD score..J Gastrointest Surg2009;13:2268-75

[33] Fan ST,Lo CM,Wong J.Hospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis..Arch Surg1995;130:198-203

[34] Belli G,D'Agostino A,Langella S,Belli A.Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results..Surg Endosc2007;21:2004-11

[35] Kanazawa A,Shimizu S,Yamazoe S,Kubo S.Impact of laparoscopic liver resection for hepatocellular carcinoma with F4-liver cirrhosis..Surg Endosc2013;27:2592-7

[36] Nguyen KT,Geller DA.World review of laparoscopic liver resection-2,804 patients..Ann Surg2009;250:831-41

[37] Belli G,Fantini C,Cioffi L,Russo G.Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis..Br J Surg2009;96:1041-8

[38] Morise Z,Kawase J,Nagata H,Arakawa S,Isetani M.Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease..World J Hepatol2013;5:487-95 PMCID:PMC3782686

[39] Abdel-Atty MY,Jagot P.Laparoscopy extends the indications for liver resection in patients with cirrhosis..Br J Surg1999;86:1397-400

[40] Brytska N,Shehta A,Cho JY.Laparoscopic liver resection for hepatitis B and C virus-related hepatocellular carcinoma in patients with Child B or C cirrhosis..Hepatobiliary Surg Nutr2015;4:373-8

[41] Worhunsky DJ,Tran TB,Poultsides GA,Visser BC.Laparoscopic hepatectomy in cirrhotics: safe if you adjust technique..Surg Endosc2016;30:4307-14

[42] Gold JS,Kornprat P,Gönen M,De Matteo RP,D'Angelica M.Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome: trends in treatment over time in 440 patients..Ann Surg2008;247:109-17

[43] Ishizawa T,Aoki T,Inoue Y,Imamura H,Kokudo N.Neither multiple tumors nor portal hypertension are surgical contraindications for hepatocellular carcinoma..Gastroenterology2008;134:1908-16

[44] Vauthey JN,Esnaola NF,Belghiti J,Curley SA,Regimbeau JM,Cleary KR.Simplified staging for hepatocellular carcinoma..J Clin Oncol2002;20:1527-36

[45] Yuki K,Sakamoto M,Shimosato Y.Growth and spread of hepatocellular carcinoma. A review of 240 consecutive autopsy cases..Cancer1990;66:2174-9

[46] Ishizawa T,Kokudo N.Laparoscopic segmentectomy of the liver: from segment I to VIII..Ann Surg2012;256:959-64

[47] Cho JY,Yoon YS,Lee W.Outcomes of laparoscopic right posterior sectionectomy in patients with hepatocellular carcinoma in the era of laparoscopic surgery..Surgery2015;158:135-41

[48] Truant S,Hebbar M,Fromont G,Leteurtre E,Pruvot FR.Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study..Surg Endosc2011;25:3668-77

[49] Belli G,Belli A.Laparoscopic liver resection for hepatocellular carcinoma in cirrhosis: long-term outcomes..Dig Surg2011;28:134-40

[50] Han HS,Ahn S,Cho JY.Laparoscopic versus open liver resection for hepatocellular carcinoma: case-matched study with propensity score matching..J Hepatol2015;63:643-50

[51] Morise Z,Cherqui D,Belli G.Can we expand the indications for laparoscopic liver resection? A systematic review and meta-analysis of laparoscopic liver resection for patients with hepatocellular carcinoma and chronic liver disease..J Hepatobiliary Pancreat Sci2015;22:342-52

[52] Xiong JJ,Javed MA,Mukherjee R,Sutton R,Hu WM.Meta-analysis of laparoscopic vs. open liver resection for hepatocellular carcinoma..World J Gastroenterol2012;18:6657-68 PMCID:PMC3516221

[53] Belli A,Russo G.Liver resection for hepatocellular carcinoma in patients with portal hypertension: the role of laparoscopy..Hepatobiliary Surg Nutr2015;4:417-21

[54] Qiu J,Shen J,Zou R,He W,Chen G,Yuan Y.Resection versus ablation in hepatitis B virus-related hepatocellular carcinoma patients with portal hypertension: a propensity score matching study..Surgery2015;158:1235-43