Abstract
We have performed laparoscopic hepatectomy (LH) to treat HCC in patients with cirrhosis. In patients with hepatic cirrhosis, the perioperative blood control in cirrhotic patients is more important procedure than that in normal liver patients. Since we initiated LH, the use of pre-coagulation technique with microwave obtained satisfactory hemostasis during liver parenchymal transection. We retrospectively investigated 35 HCC patients with cirrhosis who had performed laparoscopic partial hepatectomy using pre-coagulation. Pre-coagulation technique with laparoscopic coagulation shears was able to performed LH in all cases without Pringle maneuver. Intraoperative blood loss averaged 206.8±234.0 cc. The study group had one case of grade II prolonged fever, two cases of grade II ascites, and one case of grade IIIa biliary fistula. The postoperative length of stay averaged 10.8±5.2 days. Although the development of the energy devices and Pringle maneuver have decreased the use of pre-coagulation technique especially in normal liver, pre-coagulation technique is one of useful options in laparoscopic partial hepatectomy for HCC patients with cirrhosis.
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