A case of laparoscopic hepatectomy for recurrent hepatocellular carcinoma

Abstract

Conventional hepatectomy is an effective way to treat hepatocellular carcinoma. However, it is invasive and stressful. The use of laparoscopy in hepatectomy, while technically demanding, reduces surgical invasiveness and stressfulness but still achieves complete resection with adequate margins. Compared with conventional hepatectomy, laparoscopic hepatectomy provides a better chance and situation for further surgery in the case of recurrence of hepatocellular carcinoma. Even aged patients can successfully endure repeated hepatectomy using laparoscopy, as shown in the present report. This report presents a case of repeated laparoscopic hepatectomy treating hepatocellular carcinoma and its recurrence in an aged patient having cirrhosis, a disease causing extra difficulty for performing laparoscopic hepatectomy. The report also describes techniques of the operation and displays characteristic results of laparoscopic hepatectomy such as smaller wounds, less blood loss, less pain, less scars and adhesion, shorter postoperative hospital stay, and faster recovery.

Figure 1

Contrast CT scan of the abdomen. A, B: CT scan of the abdomen showing a 2.5-cm tumor in segment 5 of the liver (arrow); C: CT scan of the abdomen showing a 3-cm tumor in the left lateral segment of the liver (arrow).

Figure 2

Port placement for laparoscopic hepatectomy.

Figure 3

Intraoperative ultrasound scan of the liver showing a tumor measuring 23.9 mm × 21.4 mm in segment 5.

Figure 4

The 2.5-cm resected tumor that originated in segment 5 of the liver after laparoscopic wedge excision.