Indications and technique for laparoscopic liver resection in patients with hepatocellular carcinoma and liver cirrhosis

摘要

Liver resection is the preferred initial treatment option for solitary or limited multifocal hepatocellular carcinoma(HCC).However,because of the characteristics of HCC,including its high recurrence rate and the frequent presence of chronic hepatitis and cirrhosis,both curability and invasiveness must be considered when selecting a treatment for HCC.Laparoscopic liver resection(LLR)is minimally invasive and increasingly performed worldwide as a curative surgical option for treatment of liver tumors.The 2014 International Consensus Conference on LLR concluded that minor LLRs are now standard practice.Meta-analyses suggest that,as compared with open hepatectomy,LLR for patients with HCC,including those with cirrhosis,resulted in less blood loss,lower postoperative hospitalization rates,and similar oncological outcomes.Although candidates for this procedure should be carefully evaluated,LLR appears to be a feasible option for treatment of HCC with liver cirrhosis.This review describes the indications for LLR in this patient subgroup and offers guidance on appropriate surgical technique.