Pure laparoscopic right hemihepatectomy for hepatocellular carcinoma via the anterior approach

Abstract

Objective To study the feasibility and safety of pure laparoscopic right hemihepatectomy for hepatocellular carcinoma via the anterior approach. Methods The data of five patients with hepatocellular carcinoma who underwent pure laparoscopic right hemihepatectomy at the First People's Hospital of Foshan between December 2013 and December 2016 were retrospectively analyzed. Patients' operation time, blood loss, blood transfusion rate, surgical margins, hospital stay, complication and short term outcomes were reviewed. Results All the five patients completed pure laparoscopic right hemihepatectomy without conversion to open surgery. The average (range) operation time was 6.0 (5~8) h. The average blood loss was 340 (110~600) ml. No patient received blood transfusion. The average surgical margin was 2.4 (1~4.5) cm. The average postoperative hospital stay was 7 (4~15) d. The average follow-up was 22 (2~38) months. Three patients experienced postoperative complications, which included ascites, pleural effusion, and ascites accompanied by biliary leakage, respectively. The last patient recovered well from drainage. No liver failure, cancer recurrence or death was noted. Conclusions This study demonstrated that pure laparoscopic right hemihepatotectomy via the anterior approach is a minimally invasive procedure which has the advantage of fast postoperative recovery. It was feasible and safe to treat hepatocellular carcinoma with favorable short-term outcomes. Key words: Liver neoplasm; Laparoscopic hepatectomy; Anterior approach; Hepatic pedicle