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Laparoscopic Right Hemihepatectomy for Hepatocellular Carcinoma

Abstract

Background

Although laparoscopic liver resection has been widely adopted, laparoscopic right hepatectomy remains a challenging procedure. This video shows the relevant technical maneuvers in each step of a total laparoscopic right hepatectomy.

Patients and Methods

A 47-year-old man was admitted for evaluation of an incidental hepatic mass noted on a health screening test. Two months ago, transarterical chemoembolization was performed for a 3.5-cm hepatocellular carcinoma (HCC), which was located in S7–8; a follow-up abdominal computed tomography (CT) revealed incomplete necrosis of the HCC. The laboratory studies were positive for hepatitis B viral markers and a normal level of alpha-fetoprotein level. The preoperative liver function was Child-Pugh class A. A laparoscopic right hemihepatectomy was performed for this lesion. An anatomic resection of the right liver was possible with selective control of a Glissonian pedicle to the right liver.

Results

The operating time was 305 min. The estimated intraoperative blood loss was approximately 300 ml; an intraoperative transfusion was not necessary. The postoperative pathology confirmed a 3.5 × 2.8 × 2.7 cm HCC with safe margins. The patient was discharged on the 9th postoperative day without any postoperative complications.

Conclusion

A laparoscopic right hepatectomy is feasible for patients with HCC, although the operative technique is still demanding.

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References

  1. 1.

    Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009;250:831–41.

  2. 2.

    Abu Hilal M, Pearce NW. Laparoscopic left lateral liver sectionectomy: a safe, efficient, reproducible technique. Dig Surg. 2008;25:305–8.

  3. 3.

    Chang S, Laurent A, Tayar C, Karoui M, Cherqui D. Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg. 2007;94:58–63.

  4. 4.

    Dagher I, O’Rourke N, Geller DA, et al. Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg. 2009;250:856–60.

  5. 5.

    Cho JY, Han HS, Yoon YS, Shin SH. Outcomes of laparoscopic liver resection for lesions located in the right side of the liver. Arch Surg. 2009;144:25–9.

  6. 6.

    Koffron AJ, Auffenberg G, Kung R, Abecassis M. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg. 2007;246:385–92 (discussion 392–4).

  7. 7.

    Dagher I, Caillard C, Proske JM, Carloni A, Lainas P, Franco D. Laparoscopic right hepatectomy: original technique and results. J Am Coll Surg. 2008;206:756–60.

  8. 8.

    Machado MA, Makdissi FF, Galvao FH, Machado MC. Intrahepatic Glissonian approach for laparoscopic right segmental liver resections. Am J Surg. 2008;196:e38–42.

  9. 9.

    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;198:173–7.

  10. 10.

    Han HS, Cho JY, Yoon YS. Techniques for performing laparoscopic liver resection in various hepatic locations. J Hepatobiliary Pancreat Surg. 2009;16:427–32.

  11. 11.

    Yoon YS, Han HS, Choi YS, et al. Total laparoscopic right posterior sectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A. 2006;16:274–7.

  12. 12.

    Yoon YS, Han HS, Cho JY, Ahn KS. Totally laparoscopic central bisectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A. 2009;19:653–6.

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Author information

Correspondence to Ho-Seong Han MD, PhD.

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Han, H., Yoon, Y., Cho, J.Y. et al. Laparoscopic Right Hemihepatectomy for Hepatocellular Carcinoma. Ann Surg Oncol 17, 2090–2091 (2010). https://doi.org/10.1245/s10434-010-1066-4

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Keywords

  • Inferior Vena Cava
  • Hepatic Vein
  • Laparoscopic Liver Resection
  • Ultrasonic Shear
  • Left Lateral Sectionectomy