Evidence supporting laparoscopic major hepatectomy

Cheek, Susannah; Sucandy, Iswanto; Tsung, Allan; Marsh, J. Wallis; Geller, David A.

doi:10.1002/jhbp.338

Cited by 20 publications

(9 citation statements)

References 35 publications

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“…370 Reported morbidity and mortality in major laparoscopic-robotic LR series collected in very early and early HCC are 10-15% (including laparotomic conversions) and 1%, respectively. 371,372 d. For single HCC >3 cm LR is cost-effective. When the perspectives on treatment effectiveness and cost are combined and metaanalysed to replace the absence of RCTs in patients receiving resection or ablation for early tumours, LR prevails over ablation in single HCC above 3 cm, while uncertainty still remains for nodules 2-3 cm in size.…”

Section: Extent Of Hepatectomy and Surgical Invasivenessmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Galle¹,

Forner²,

Llovet³

et al. 2018

Journal of Hepatology

6,952

4,351

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Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Hepatocellular carcinoma represents about 90% of primary liver cancers and constitutes a major global health problem. The following Clinical Practice Guidelines will give up-to-date advice for the clinical management of patients with hepatocellular carcinoma, as well as providing an in-depth review of all the relevant data leading to the conclusions herein.

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Section: Extent Of Hepatectomy and Surgical Invasivenessmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Galle¹,

Forner²,

Llovet³

et al. 2018

Journal of Hepatology

6,952

4,351

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“…These promising results have encouraged surgeons to further explore the application of laparoscopic techniques in complex surgery. In fact, a similar process can also be observed in laparoscopic pancreaticoduodenectomy (LPD) [41] and laparoscopic hepatectomy [42], which was initially controversial but has been gradually accepted. For example, LPD was once regarded as the Mt.…”

Section: Discussionmentioning

confidence: 83%

Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center.

Li¹,

Xiong²,

Ye³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Introduction: The landscape of surgical treatments for hepatobiliary disease was significantly changed after the advent of laparoscopy. Many kinds of complex laparoscopic procedures can be routinely performed at present, but radical resection of hilar cholangiocarcinoma (HC) by laparoscopy is still highly contentious. Aim: To describe our primary experience with laparoscopic radical resection for HC and determine the safety and feasibility of this procedure. Material and methods: Between December 2015 and November 2019, 32 patients planned to undergo curative-intent laparoscopic resection of HC in our department. The perioperative and long-term outcomes of these patients were retrospectively analyzed. Results: Laparoscopic surgery with radical resection was ultimately performed in 24 (75.0%) patients; 3 (9.3%) patients were found to be unresectable at the preliminary exploration stage, and 5 (15.7%) patients converted from laparoscopy to laparotomy. The operation time and blood loss were 476.95 ±133.89 min and 568.75 ±324.01 ml, respectively. A negative margin was achieved in 19 (79.1%) of the laparoscopy patients. Three (12.5%) patients were identified with microscopic positive margins, and 2 (8.4%) patients underwent macroscopic residual tumor resection (R2). The length of postoperative stay was 23.3 ±11.7 days. Severe morbidity occurred in 4 (16.6%) patients. The actuarial 3-year overall survival and disease-free survival for patients who underwent laparoscopic surgery were 49.1% and 47.0%, respectively. Conclusions: Laparoscopic radical resection for HC is safe and feasible in experienced hands for highly selected patients but is still in its initial stages. When adequate oncologic resection is performed, the laparoscopic approach does not adversely influence the prognosis of the patient.

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“…In order to reduce surgical stress and improve outcomes, in the last ten years, laparoscopic and robotic techniques have been applied in liver surgery, which have been shown to be safe and effective approaches, with morbidity and mortality in major laparoscopic-robotic series in very early and early HCC of 10–15% and 1%, respectively [ 35 , 56 , 57 , 58 ]. Laparoscopic-robotic resection of HCC, in particular when the tumours are mainly located in superficial peripheral positions of the liver, provides optimal survival outcomes and minimizes complications and hospital stay [ 57 , 59 ].…”

Section: Hcc Treatment In Elderly Patients According To Bclc Stagementioning

confidence: 99%

How to Treat Hepatocellular Carcinoma in Elderly Patients

Federico¹,

Giunta

Pappalardo

et al. 2021

Pharmaceuticals

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Hepatocellular carcinoma (HCC) is the primary tumour of the liver with the greatest incidence, particularly in the elderly. Additionally, improvements in the treatments for chronic liver diseases have increased the number of elderly patients who might be affected by HCC. Little evidence exists regarding HCC in old patients, and the elderly are still underrepresented and undertreated in clinical trials. In fact, this population represents a complex subgroup of patients who are hard to manage, especially due to the presence of multiple comorbidities. Therefore, the choice of treatment is mainly decided by the physician in the clinical practice, who often tend not to treat elderly patients in order to avoid the possibility of adverse events, which may alter their unstable equilibrium. In this context, the clarification of the optimal treatment strategy for elderly patients affected by HCC has become an urgent necessity. The aim of this review is to provide an overview of the available data regarding the treatment of HCC in elderly patients, starting from the definition of “elderly” and the geriatric assessment and scales. We explain the possible treatment choices according to the Barcelona Clinic Liver Cancer (BCLC) scale and their feasibility in the elderly population.

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Evidence supporting laparoscopic major hepatectomy

Cited by 20 publications

References 35 publications

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center.

How to Treat Hepatocellular Carcinoma in Elderly Patients

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