Surgical resection of hepatocellular carcinoma – initial experience and results of a newly established HPB unit

Abstract

Hepatic resection of hepatocellular carcinoma (HCC) is a major operation in high-risk patients, with a postoperative death rate of 5% in most recent series. From July 2015 to December 2017, 17 patients underwent liver resection (LR) as treatment for HCC at our unit. The aim was to review our experience with LR in the treatment of patients with HCC, in a newly formed HPB unit, evaluating patient characteristics, surgical technique, results and survival. A prospectively maintained database was used. Fourteen patients were male (82.3%), with an average age of 71 years (Min 51; Max 78), and with 53% of the patients being cirrhotic. Operative time was 208 minutes (Min 90; Max 360), with two patients needing intraoperative blood transfusion. A total of 2 subsegmentectomies, 10 monosegmentectomies, 2 bisegmentectomies, and 3 major hepatectomies were performed. One patient underwent laparoscopic liver resection. Median tumor size was 4,2cm (Min 1; Max 22). Median hospital stay was 12 days (Min 6; Max 33). There was one perioperative death due to sepsis and multiorgan failure. Three patients (17.6%) died during follow up due to disease recurrence and progression. There are 76.4% of patients alive. This small series underlines that LR for HCC is a safe and feasible procedure, although a longer follow up is warranted to accurately determine overall and disease free survival. LR for HCC should be offered as the first option to patients with preserved hepatic function and limited disease who do not fulfill the criteria or are too old for liver transplant.