Laparoscopic Hepatectomy is a Feasible and Safe Choice for Primary Hepatocellular Carcinoma


Hepatocecullar carcinoma
Short-term outcome
Long-term outcome

How to Cite

Lee Y-H, Huang Y-T, Kuo T-L, Lee M-C, Chen Y-C. Laparoscopic Hepatectomy is a Feasible and Safe Choice for Primary Hepatocellular Carcinoma. Surg Insights [Internet]. 2022 Sep. 8 [cited 2024 Jul. 19];. Available from:


Introduction: Laparoscopic hepatectomy (LH) for hepatocellular carcinoma (HCC) is well-known for its advantages but its specific long-term outcomes are unknown. This study aimed to analyze the perioperative, short-term, and long-term outcomes between LH and open hepatectomy (OH) for primary HCC who underwent LH during the developing period of LH in a single center.
Methods: This retrospective study included patients diagnosed with primary HCC who underwent hepatectomy between January 2013 and December 2019. The patients were divided into the LH (n=63) and OH (n=96) groups. Demographic and perioperative data were collected.
Results: A higher percentage of patients in the OH group underwent major resection (38.5% vs. 11.1%, p < 0.001). The operative time was 47 minutes shorter and the intraoperative blood loss was 105 mL less in the LH group. The major postoperative complication rate (33.3% vs. 50.0%, p = 0.05) and the 90-day readmission rate (3.2% vs. 12.5%, p = 0.048) were lower in the LH group. The overall survival and disease-free survival were similar between the two groups.
Conclusions: LH is a feasible and safe alternative for primary HCC, with less blood loss, fewer major complications, and shorter postoperative hospital stay. LH does not worsen short- or long-term outcomes.


International Agency for Research on Cancer. Liver. World Health Organization. Available at 2020.

Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. Journal of hepatology 2022; 76(3): 681-93.

Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet 2018; 391(10127): 1301-14.

Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Annals of surgery 2009; 250(5): 831-41.

Cherqui D, Husson E, Hammoud R, et al. Laparoscopic liver resections: a feasibility study in 30 patients. Annals of surgery 2000; 232(6): 753-62.

Ishii J, Otsuka Y, Tsuchiya M, et al. Application of microwave tissue coagulator in laparoscopic hepatectomy for the patients with liver cirrhosis. Journal of microwave surgery 2012; 30: 213-7.

Buell JF, Thomas MJ, Doty TC, et al. An initial experience and evolution of laparoscopic hepatic resectional surgery. Surgery 2004; 136(4): 804-11.

Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. The British journal of surgery 2006; 93(1): 67-72.

Chen J, Li H, Liu F, Li B, Wei Y. Surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma for various resection extent. Medicine (Baltimore) 2017; 96(12): e6460.

Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Archives of surgery 2003; 138(11): 1198-206; discussion 1206.

Strasberg SM, Belghiti J, Clavien P-A, et al. The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000; 2(3): 333-9.

Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Annals of surgery 2009; 250(2): 187-96.

Koch M, Garden OJ, Padbury R, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 2011; 149(5): 680-8.

Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011; 149(5): 713-24.

Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: the Louisville statement, 2008. Annals of surgery 2009; 250(5): 825-30.

Wakabayashi G. What has changed after the Morioka consensus conference 2014 on laparoscopic liver resection? Hepatobiliary surgery and nutrition 2016; 5(4): 281-9.

Morise Z, Wakabayashi G. First quarter century of laparoscopic liver resection. World journal of gastroenterology 2017; 23(20): 3581-8.

Wakabayashi G, Cherqui D, Geller DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Annals of surgery 2015; 261(4): 619-29.

Asiyanbola B, Chang D, Gleisner AL, et al. Operative mortality after hepatic resection: are literature-based rates broadly applicable? Journal of gastrointestinal surgery 2008; 12(5): 842-51.

Csikesz NG, Simons JP, Tseng JF, Shah SA. Surgical specialization and operative mortality in hepato-pancreatico-biliary (HPB) surgery. Journal of gastrointestinal surgery 2008; 12(9): 1534-9.

Eppsteiner RW, Csikesz NG, Simons JP, Tseng JF, Shah SA. High volume and outcome after liver resection: surgeon or center? Journal of gastrointestinal surgery 2008; 12(10): 1709-16; discussion 1716; discussion.

Ho KM, Cheng KC, Chan FK, Yeung YP. Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: A propensity case-matched analysis of the long-term survival. Annals of hepato-biliary-pancreatic surgery 2021; 25(1): 1-7.

Hendi M, Lv J, Cai XJ. Current status of laparoscopic hepatectomy for the treatment of hepatocellular carcinoma: A systematic literature review. Medicine (Baltimore) 2021; 100(50): e27826.

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Copyright (c) 2022 Yi-Hsuan Lee, Yu-Ting Huang, Tsai-Ling Kuo, Ming-Che Lee, Yen-Cheng Chen


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