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Advances and challenges in laparoscopic surgery in the management of hepatocellular carcinoma.

TitleAdvances and challenges in laparoscopic surgery in the management of hepatocellular carcinoma.
Publication TypeJournal Article
Year of Publication2017
AuthorsZiogas, I. A., & Tsoulfas G.
JournalWorld J Gastrointest Surg
Volume9
Issue12
Pagination233-245
Date Published2017 Dec 27
ISSN1948-9366
Abstract

Hepatocellular carcinoma is the fifth most common malignancy and the third most common cause of cancer-related mortality worldwide. From the wide variety of treatment options, surgical resection and liver transplantation are the only therapeutic ones. However, due to shortage of liver grafts, surgical resection is the most common therapeutic modality implemented. Owing to rapid technological development, minimally invasive approaches have been incorporated in liver surgery. Liver laparoscopic resection has been evaluated in comparison to the open technique and has been shown to be superior because of the reported decrease in surgical incision length and trauma, blood loss, operating theatre time, postsurgical pain and complications, R0 resection, length of stay, time to recovery and oral intake. It has been reported that laparoscopic excision is a safe and feasible approach with near zero mortality and oncologic outcomes similar to open resection. Nevertheless, current indications include solid tumors in the periphery < 5 cm, especially in segments II through VI, while according to the consensus laparoscopic major hepatectomy should only be performed by surgeons with high expertise in laparoscopic and hepatobiliary surgery in tertiary centers. It is necessary for a surgeon to surpass the 60-cases learning curve observed in order to accomplish the desirable outcomes and preserve patient safety. In this review, our aim is to thoroughly describe the general principles and current status of laparoscopic liver resection for hepatocellular carcinoma, as well as future prospects.

DOI10.4240/wjgs.v9.i12.233
Alternate JournalWorld J Gastrointest Surg
PubMed ID29359029
PubMed Central IDPMC5752958

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