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.
Similar content being viewed by others
References
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.
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.
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.
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.
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.
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.
Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection — 2804 patients. Ann Surg 2009;250(5):831–841.
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.
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.
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.
Author information
Authors and Affiliations
Rights 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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-010-4283-3