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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 6
Jun.  2014
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Clinical value of laparoscopic hepatectomy in liver cancer patients with cirrhosis

DOI: 10.3969/j.issn.1001-5256.2014.06.019
  • Received Date: 2013-11-27
  • Published Date: 2014-06-20
  • Objective To compare the perioperative outcomes of laparoscopic hepatectomy ( LH) versus open hepatectomy ( OH) for liver cancer patients with cirrhosis. Methods From September 2010 to June 2012, 78 liver cancer patients with cirrhosis hospitalized in Renmin Hospital affiliated to Wuhan University were considered for liver resection; among them, 32 patients were treated with LH, and 46 patients with OH. Intraoperative and postoperative conditions and tumor recurrence were compared between the two groups. Group t- test and paired t- test were used for measurement data, while chi- square test for enumeration data. Results The comparison of two groups indicated that the following indicators were significantly lower in the LH group than in the OH group: intraoperative blood loss ( t = 0. 057, P = 0. 040) , incidence of postoperative complications ( electrolyte imbalance, bile leakage, and ascites: t = 3. 001, 3. 241, and 4. 255, respectively, P< 0. 05 for all) , liver function on the first day after operation ( AST and ALT: t = 3. 427 and 3. 201, P = 0. 001 and 0. 002) , postoperative time to oral intake ( t = 3. 012, P = 0. 001) , length of hospital stay ( t = 2. 157, P = 0. 003) , and tumor recurrence ( t = 2. 751, P =0. 006) ; whereas, the operative time in LH group was significantly longer than that in OH group ( t = 3. 101, P = 0. 003) . Conclusion Compared with OH, LH has various advantages in liver cancer patients with cirrhosis, such as smaller abdominal incision, less intraoperative blood loss, lower incidence of postoperative ascites, decreased postoperative complications, shorter hospital stay, and lower incidence of tumor recurrence.

     

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  • [1]REICH H, MCGLYNN F, DECAPRIO J, et al.Laparoscopic excision of benign liver lesions[J].Obstel Gynecol, 1991, 78 (5 Pt2) :956-958.
    [2]YANG CM.Recent advance in laparoscopic hepatectomy[J].Chin J Hepatobiliary Surg, 2011, 8 (8) :610-613. (in Chinese) 杨春明.腹腔镜肝切除术的进展[J].中华肝胆外科杂志, 2011, 8 (8) :610-613.
    [3]BUELL JF, CHERQUM, GELLERDA, et al.The international position on laparoscopic liver surgery:the louisville statement, 2008[J].Ann Surg, 2009, 250 (5) :825-830.
    [4] CHEN XX, HUANG SR, LIN Y, et al.Laparoscopic hepatectomy vs open hepatectomy for hepatocellular carcinoma[J].Chin J Gen Surg, 2010, 9 (5) :729-723. (in Chinese) 陈小勋, 黄顺荣, 林源, 等.腹腔镜与开腹手术治疗肝癌的临床对比[J].中华普通外科杂志, 2010, 9 (5) :729-723.
    [5]GAO L, JING X, ZHAO XM, et al.Hemodynamics of portal vein in cirrhotic patients with esophageal varices[J].J Clin Hepatol, 2010, 26 (3) :297-300. (in Chinese) 高磊, 经翔, 赵新民, 等.肝硬化食道静脉曲张的门脉血流动力学改变及相关参数的研究分析[J].临床肝胆病杂志, 2010, 26 (3) :297-300.
    [6]BELLI G, FANTINI C, D'AGOSTINO A, et al.Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis:short-and middle-term results[J].Surg Endosc, 2007, 21 (11) :2004-2011.
    [7]ISAMU H, HIDEYUKI Y, HIROAKI S, et al.Usefulness of pure laparoscopic hepatectomy for hepatocellular carcinoma in a severely cirrhotic patient[J].Case Rep Gastroenterol, 2013, 7 (2) :308-313.
    [8]MORISE Z, SUGIOKAZ A, KAWABE N, et al.Pure laparoscopic hepatectomy for hepatocellular carcinoma patients with severe liver cirrhosis[J].Asian J Endosc Surg, 2011, 4 (3) :143-146.
    [9]KANEKO H, TSUCHIYA M, OTSUKA Y, et al.Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients[J].J Hepatobiliary Pancreat Surg, 2009, 16 (4) :433-438.
    [10]LAURENT A, CHERQUI D, LESURTEL M, et al.Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease[J].Arch Surg, 2003, 138 (7) :763-769.
    [11] ZHENG SG, LI JW, CHEN J, et al.Clinical application of laparoscopic hepatectomy[J].Chin J Hepatobiliary Surg, 2011, 8 (17) :614-617. (in Chinese) 郑树国, 李建伟, 陈健, 等.腹腔镜肝切除术临床应用的经验体会[J].中华肝胆外科杂志, 2011, 8 (17) :614-617.
    [12]DANIEL C, ALEXIS L, CLAUDE T, et al.Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease midterm results and perspectives[J].Ann Surg, 2006, 243 (4) :499-506.
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