Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Apr 15;14(8):2012.
doi: 10.3390/cancers14082012.

Leaping the Boundaries in Laparoscopic Liver Surgery for Hepatocellular Carcinoma

Gianluca Cassese  1   2 , Ho-Seong Han  1 , Boram Lee  1 , Hae Won Lee  1 , Jai Young Cho  1 , Roberto Troisi  2
Affiliations
Review

Leaping the Boundaries in Laparoscopic Liver Surgery for Hepatocellular Carcinoma

Gianluca Cassese et al. Cancers (Basel). .

Abstract

The minimally invasive approach for hepatocellular carcinoma (HCC) had a slower diffusion compared to other surgical fields, mainly due to inherent peculiarities regarding the risks of uncontrollable bleeding, oncological inadequacy, and the need for both laparoscopic and liver major skills. Recently, laparoscopic liver resection (LLR) has been associated with an improved postoperative course, including reduced postoperative decompensation, intraoperative blood losses, length of hospitalization, and unaltered oncological outcomes, leading to its adoption within international guidelines. However, LLR for HCC still faces several limitations, mainly linked to the impaired function of underlying parenchyma, tumor size and numbers, and difficult tumor position. The aim of this review is to highlight the state of the art and future perspectives of LLR for HCC, focusing on key points for overcoming currents limitations and pushing the boundaries in minimally invasive liver surgery (MILS).

Keywords: hepatocellular carcinoma; laparoscopic liver resection; minimally invasive liver surgery; overcoming the limits.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Laparoscopic resection of caudate lobe for hepatocellular carcinoma. (A) CT scan with arterial wash-in. (B) ICG enhancement of the lesion, assuring negative resection margins. (C) Parenchymal transection. (D) Securing spigelian vessels.
Figure 2
Figure 2
Laparoscopic right posterior sectionectomy. (A) CT scan with portal wash-out. (B) Mobilization of right lobe. (C) Selective ligation of right posterior portal branch. (D) Parenchymal transection by using ultrasonic cavitron.
See this image and copyright information in PMC

References

    1. Ferlay J., Soerjomataram I., Dikshit R., Eser S., Mathers C., Rebelo M., Parkin D.M., Forman D., Bray F. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer. 2015;136:E359–E386. doi: 10.1002/ijc.29210. - DOI - PubMed
    1. Marrero J.A., Kulik L.M., Sirlin C.B., Zhu A.X., Finn R.S., Abecassis M.M., Roberts L.R., Heimbach J.K. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatol. Baltim. Md. 2018;68:723–750. doi: 10.1002/hep.29913. - DOI - PubMed
    1. Llovet J.M., Kelley R.K., Villanueva A., Singal A.G., Pikarsky E., Roayaie S., Lencioni R., Koike K., Zucman-Rossi J., Finn R.S. Hepatocellular carcinoma. Nat. Rev. Dis. Primer. 2021;7:6. doi: 10.1038/s41572-020-00240-3. - DOI - PubMed
    1. Tribillon E., Barbier L., Goumard C., Irtan S., Perdigao-Cotta F., Durand F., Paradis V., Belghiti J., Scatton O., Soubrane O. When Should We Propose Liver Transplant After Resection of Hepatocellular Carcinoma? A Comparison of Salvage and De Principe Strategies. J. Gastrointest. Surg. Off. J. Soc. Surg. Aliment. Tract. 2016;20:66–76. doi: 10.1007/s11605-015-3018-6. - DOI - PubMed
    1. Graf D., Vallböhmer D., Knoefel W.T., Kröpil P., Antoch G., Sagir A., Häussinger D. Multimodal treatment of hepatocellular carcinoma. Eur. J. Intern. Med. 2014;25:430–437. doi: 10.1016/j.ejim.2014.03.001. - DOI - PubMed

LinkOut - more resources