Laparoscopic liver resection for hepatocellular carcinoma with cirrhosis in a single institution

Background: In a statement by the second International Consensus Conference for Laparoscopic LiverResection (LLR), minor LLR was confirmed to be a standard surgical practice, as it has become adoptedby an increasing proportion of surgeons. However, it is unclear whether this applies to the more complexgroup of patients suffering from cirrhosis. Therefore, the aim of this retrospective study was to comparethe feasibility and safety of LLR for hepatocellular carcinoma (HCC) between non-liver cirrhosis (NLC)patients and liver cirrhosis (LC) patients at a single high-volume laparoscopy center.Methods: From the beginning of 2000 to the end of 2013, open liver resection (OLR) was performed in 99HCC patients, and LLR was in 118. The HCC patients who underwent LLR were divided into NLC-LLR(n=60) and LC-LLR (n=58) groups, and we compare the short-term outcomes between them.Results: There was no significant difference in the incidence of blood loss and transfusion requirementsbetween the NLC-LLR group and the LC-LLR group, although wedge resection was mainly performed inthe LC-LLR group. There was no significant difference in the complication rate between the two groups,and the remarkable finding was that there was a significantly lower incidence of postoperative ascites in theLC-LLR group than in the NLC-LLR group.Conclusions: According to our experience, it appears that LLR for selected HCC patients with cirrhosisis a feasible and promising procedure that is associated with less blood loss and fewer postoperativecomplications, especially the incidence of postoperative ascites. Further investigations are clearly warranted.