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Repeat laparoscopic anatomical liver resection in a hepatocellular carcinoma patient:a case report

Hepatoma Research 2022年第1期8卷 248-253页

作者： Kazuharu Igarashi Kohei Mishima Takahiro Ozaki Go Wakabayashi Department of Surgery Ageo Central General HospitalAgeoSaitama 362-8588Japan Department of General-Pediatric Hepatobiliary Pancreatic Surgery Kitasato University School of MedicineSagamiharaKanagawa 252-0374Japan

Anatomical resection(AR)has been reported to achieve better long-term outcomes than non-anatomical resection for the treatment of hepatocellular carcinoma(HCC).The surgical feasibility and oncological significance of laparoscopic AR(LAR),especially“subsegment resection”,“cone unit resection”,and repeat LAR for HCC,remain unproven.We present a 67-year-old patient with alcoholic liver cirrhosis and HCC who underwent full LAR three times,focusing on the technical aspects of the Glissonean approach.Repeating LAR for recurrent HCC could be a safe and feasible procedure.However,HCC recurred in the neighboring segment twice,even though pathological vascular invasion and marginal remnants were not confirmed.We should investigate the oncological significance and advancements in subsegmentectomy and cone unit resection,in the future.

关键词： Repeat laparoscopic anatomical liver resection HCC Glissonean approach subsegmentectomy cone unit resection

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Case report of the fourth laparoscopic liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver

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Hepatoma Research 2016年第1期2卷 253-258页

作者： Zenichi Morise Masashi Isetani Norihiko Kawabe Hirokazu Tomishige Hidetoshi Nagata Satoshi Arakawa Masahiro Ikeda Kenshiro Kamio Department of Surgery Fujita Health University School of MedicineToyoakeAichi 470-1192Japan Department of Surgery Fujita Health University Banbuntane Houtokukai HospitalNagoyaAichi 454-8509Japan

A 73-year-old woman with liver cirrhosis caused by hepatitis C virus(HCV)underwent treatment of three hepatocellular carcinomas(HCCs)in liver segment 4,following three previous laparoscopic liver resections(LLRs)over 73 months.Contrast-enhanced computed 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 284 min,there was 50 mL of intra-operative bleeding and her recovery was uneventful.She was well,had experienced no recurrence and was HCV-negative,after taking oral anti-HCV therapy,21 months later.LLR is associated with fewer adhesions after surgery and requires less adhesiolysis,because the laparoscope and forceps can be used in the small spaces between adhesions.The present patient underwent four LLRs over 6 years without severe deterioration of liver functional reserve.LLR is a useful localized therapy,which can be performed repeatedly and may prolong the survival of patients with multicentric metachronous HCCs.

关键词： Laparoscopic liver resection,repeat liver resection hepatocellular carcinoma liver cirrhosis anatomical liver resection subsegmentectomy

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