Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2015; 7(7): 102-106
Published online Jul 27, 2015. doi: 10.4240/wjgs.v7.i7.102
Perspective of laparoscopic liver resection for hepatocellular carcinoma
Zenichi Morise
Zenichi Morise, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Nagoya, Aichi 454-8509, Japan
Author contributions: Morise Z solely contributed to this paper.
Conflict-of-interest statement: The author has no conflict of interest to declare.
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, FACS, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, 3-6-10, Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan. zmorise@aol.com
Telephone: +81-52-3218171 Fax: +81-52-3234502
Received: January 25, 2015
Peer-review started: January 28, 2015
First decision: March 6, 2015
Revised: May 11, 2015
Accepted: June 1, 2015
Article in press: June 2, 2015
Published online: July 27, 2015
Abstract

Liver resection (LR) for hepatocellular carcinoma (HCC) in patients with chronic liver disease (CLD) is associated with high risks of developing significant postoperative complications and multicentric metachronous lesions, which can result in the need for repeated treatments. Studies comparing laparoscopic procedures to open LR consistently report reduced blood loss and transfusions requirements, lower postoperative morbidity, and shorter hospital stays, with no differences in oncologic outcomes. In addition, laparoscopic LR is associated with reduced postoperative ascites and a lower incidence of liver failure for HCC patients with CLD, due to the reduced surgery-induced parenchymal injury to the residual liver and limited destruction of the collateral blood/lymphatic flow around the liver. Finally, this procedure facilitates subsequent repeat LR due to minimal adhesion formation and improved vision/manipulation between adhesions. These characteristics of laparoscopic LR may lead to an expansion of the indications for LR. This editorial is based on the review and meta-analysis presented at the 2nd International Consensus Conference on Laparoscopic Liver Resection in Iwate, Japan, in October 2014 (Chairperson of the congress is Professor Go Wakabayashi from the Department of Surgery, Iwate Medical University School of Medicine), which is published in the Journal of Hepato-Biliary-Pancreatic Sciences.

Keywords: Laparoscopic, Liver resection, Hepatocellular carcinoma, Chronic liver disease, Liver failure, Ascites, Indication, Repeat hepatectomy

Core tip: Liver resection (LR) for hepatocellular carcinoma patients with chronic liver disease has high risks for developing significant postoperative complications and multicentric metachronous lesions with need of repeated treatments. Laparoscopic LR has advantages of reduced surgery-induced parenchymal injury and destruction of the collateral blood/lymphatic flow, which leads to reduced production of postoperative ascites, and facilitates repeat LR because of reduced adhesion formation and improved vision/manipulation between adhesions. These characteristics of laparoscopic LR may lead to expansion of the indications for LR.