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World J Hepatol. Jul 27, 2018; 10(7): 479-484
Published online Jul 27, 2018. doi: 10.4254/wjh.v10.i7.479
Status and perspective of laparoscopic repeat liver resection
Zenichi Morise
Zenichi Morise, Department of Surgery, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan
Author contributions: Morise Z collected the data and wrote this paper.
Conflict-of-interest statement: Morise Z declares no conflicts of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zenichi Morise, MD, PhD, Professor, Department of Surgery, Fujita Health University School of Medicine, 1-98 Kutsukakecho Toyoake 470-1192, Aichi, Japan. zmorise@fujita-hu.ac.jp
Telephone: +81-562-939246 Fax: +81-562-935125
Received: March 26, 2018
Peer-review started: March 27, 2018
First decision: April 13, 2018
Revised: April 18, 2018
Accepted: May 30, 2018
Article in press: May 30, 2018
Published online: July 27, 2018
Abstract

Liver resection (LR) is now actively applied to intrahepatic recurrence of liver metastases and hepatocellular carcinoma. Although indications of laparoscopic LR (LLR) have been expanded, there are increased risks of intraoperative complications and conversion in repeat LLR. Controversy still exists for the indication. There are 16 reports of small series to date. These studies generally reported that repeat LLR has better short-term outcomes than open (reduced bleedings, less or similar morbidity and shorter hospital stay) without compromising the long-term outcomes. The fact that complete adhesiolysis can be avoided in repeat LLR is also reported. In the comparison of previous procedures, it is reported that the operation time for repeat LLR was shorter for the patients previously treated with LLR than open. Furthermore, it is speculated that LLR for minor repeat LR of cirrhotic liver can be minimized the deterioration of liver function by LR. However, further experience and evaluation of anatomical resection or resections exposing major vessels as repeat LLR, especially after previous anatomical resection, are needed. There should be a chance to prolong the overall survival of the patients by using LLR as a powerful local therapy which can be applied repeatedly with minimal deterioration of liver function.

Keywords: Hepatocellular carcinoma, Laparoscopic liver resection, Repeat surgery, Metastasis

Core tip: There are 16 reports of repeat laparoscopic liver resection (LLR). They reported that it has better short-term outcomes than open (reduced bleedings, less or similar morbidity and shorter hospital stay). The fact that complete adhesiolysis can be avoided in repeat LLR is also reported. It is speculated that LLR for minor repeat LR of cirrhotic liver can be minimized the deterioration of liver function by LR. Repeated application of LLR as a powerful local therapy, which can be applied repeatedly with minimal deterioration of liver function, could improve the overall survival of the patients.