Short-Term Outcomes of Laparoscopic Repeat Hepatectomy

Abstract

Background: Although repeat hepatectomy is an effective treatment for recurrence hepatocellular carcinoma and metastatic liver tumor, laparoscopic repeat hepatectomy (LRH) is not widely accepted and its indication has not been established. The aim of this study was to clarify feasibility and safety of LRH. Methods: Seventy-eight patients who underwent repeat hepatectomy from January 2013 to December 2019 were retrospectively reviewed. Short-term outcomes of LHR and open repeat hepatectomy (ORH) were investigated. Result: LRH and ORH were applied for 42 (53.8%) and 36 (46.2%) patients, respectively. Among LRH group, conversions to open surgery including mini laparotomy were needed for 4 patients (9.5%) due to severe adhesion (n=2) and tumor status (n=2). As compared to ORH group, number of tumors was small (median 1 vs. 2; P=0.0003), tumor size was small (median 1.95 vs. 2.45; P=0.0388) in LRH group. Previous open hepatectomy had undergone for 9 patients (21.4%) in LRH group and 27 patients (75.0%) in ORH group (P< 0.0001). Liver resection more than 2 Couinaud`s segment was performed for 21.4% in LRH group and 78.5% in ORH group (P=0.25). There was no significant difference in operation time and postoperative complication rate between two groups. Intraoperative blood loss was smaller (median 60 ml vs. 310 ml; P< 0.0001) and postoperative hospital stay was shorter (median 7 days vs. 9 days; P< 0.0001) in LRH group. Conclusion: LHR is feasible and safety option for patient with recurrent liver tumors.