Outcomes of laparoscopic right posterior sectionectomy in patients with hepatocellular carcinoma in the era of laparoscopic surgery

• Published in: Surgery 2015-07, Vol.158 (1), p.135-141
• Main Authors: Cho, Jai Young, MD, PhD, Han, Ho-Seong, MD, PhD, Yoon, Yoo-Seok, MD, PhD, Choi, YoungRok, MD, Lee, Woohyung, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - surgery; Female; Hepatectomy - methods; Humans; Laparoscopy; Liver Neoplasms - surgery; Male; Middle Aged; Surgery; Treatment Outcome
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2015.02.007

Background Although there are very few reports of laparoscopic right posterior sectionectomy (RPS), we believe this is a promising operative method for lesions confined to the right posterior section of the liver. Method Between September 2003 and June 2012, laparoscopic liver resection was performed in 408 patients at Seoul National University Bundang Hospital. We analyzed the clinical data of 24 patients who underwent laparoscopic RPS for hepatocellular carcinoma (HCC) and compared outcomes with patients who underwent open RPS ( n  = 19). Results The mean operation time was 567 minutes, and the mean postoperative hospital stay was 10.6 ± 4.8 days. The mean tumor-free margin was 3.0 ± 5.8 cm. There were no deaths or major complications. Two complications occurred, which were managed by percutaneous drainage. There were three conversions to laparotomy because of an insufficient tumor margin. These patients were treated when we had limited experience of laparoscopic resection. Extended RPS ( n  = 6), which involved RPS and resection of the right hepatic vein, was performed to achieve an adequate margin if the tumor was located very close to the right hepatic vein. The mean operation time was longer in laparoscopy group than that in open group ( P