Skip to main content
Log in

Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case

  • Case Report
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Hepatocellular carcinoma accompanied by portal hypertension and hypersplenism is difficult to treat medically and surgically due to pancytopenia and the development of collateral circulation. In this study, we were able to safely and simultaneously perform a laparoscopicallyassisted splenectomy and partial hepatectomy. The characteristics of this procedure include: (1) the shared use of a medial wound made through laparoscopically-assisted surgery; (2) improved safety for manipulating areas that were difficult to observe with a camera in a case of splenomegaly; (3) a preventive ligation of the splenic artery; (4) improved hemostatic function using LigaSure Impact; and (5) hemorrhage control through manual manipulations and the Pringle maneuver during liver parenchymal transection. The surgery was safely performed using the above points.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Chen XP, Wu ZD, Huang ZY, Qiu FZ. Use of hepatectomy and splenectomy to treat hepatocellular carcinoma with cirrhotic hypersplenism. Br J Surg 2005;92:334–339.

    Article  PubMed  Google Scholar 

  2. N’Kontchou G, Seror O, Bourcier V, Mohand D, Ajavon Y, Castera L, et al. Partial splenic embolization in patients with cirrhosis: efficacy, tolerance and long-term outcome in 32 patients. Eur J Gastroenterol Hepatol 2005;17:179–184.

    Article  PubMed  Google Scholar 

  3. Shimada M, Hashizume M, Shirabe K, Takenaka K, Sugimachi K. A new surgical strategy for cirrhotic patients with hepatocellular carcinoma and hypersplenism. Performing a hepatectomy after a laparoscopic splenectomy. Surg Endosc 2000;14:127–130.

    PubMed  CAS  Google Scholar 

  4. Endo Y, Ohta M, Shibata K, Kai S, Iwaki K, Uchida H, et al. Splenectomy for hypersplenism caused by adult T-cell leukemia: report of a case. Surg Today 2008;38:1148–1151.

    Article  PubMed  Google Scholar 

  5. Kawanaka H, Akahoshi T, Kinjo N, Konishi K, Yoshida D, Anegawa G, et al. Technical standardization of laparoscopic splenectomy harmonized with hand-assisted laparoscopic surgery for patients with liver cirrhosis and hypersplenism. J Hepatobiliary Pancreat Surg 2009;16:749–757.

    Article  PubMed  Google Scholar 

  6. Makuuchi M, Kosuge T, Takayama T, Yamazaki S, Kakazu T, Miyagawa S, et al. Surgery for small liver cancers. Semin Surg Oncol 1993;9:298–304.

    Article  PubMed  CAS  Google Scholar 

  7. Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection — 2804 patients. Ann Surg 2009;250(5):831–841.

    Article  PubMed  Google Scholar 

  8. Belli G, Limongelli P, Fantini C, D’Agostino A, Cioffi L, Belli A, et al. Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis. Br J Surg 2009;96:1041–1048.

    Article  PubMed  CAS  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. Cho A, Yamamoto H, Nagata M, Takiguchi N, Shimada H, Kainuma O, et al. Safe and feasible inflow occlusion in laparoscopic liver resection. Surg Endosc 2009;23:906–908.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ohno, T., Furui, J., Hashimoto, T. et al. Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case. Surg Today 41, 444–447 (2011). https://doi.org/10.1007/s00595-010-4283-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-010-4283-3

Key words

Navigation