title: Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients.
abstract: BACKGROUND
  We have used laparoscopic hepatectomy as a surgical treatment for HCC in patients with cirrhosis. We describe the indications, evaluate invasiveness and analyze the outcomes of laparoscopic hepatectomy.
  
  
  RESULTS
  With respect to operative method, laparoscopic hepatectomy involving either partial hepatectomy or left lateral sectionectomy is a less invasive procedure in patients with cirrhosis than conventional hepatectomy. Among our laparoscopic hepatectomy cases, operative time was shorter and bleeding was less in recent, as compared to earlier, cases. Furthermore, laparoscopic hepatectomy was less invasive than conventional hepatectomy, as determined by the E-PASS scoring system. Patients also recovered more quickly, which resulted in shorter hospital stays even for patients with cirrhosis. Both the 5-year survival rate and the rate of survival without recurrence of HCC were nearly identical to those of open conventional hepatectomy.
  
  
  CONCLUSIONS
  These findings indicate that laparoscopic hepatectomy avoids the disadvantages of standard hepatectomy for HCC in properly selected patients with cirrhosis and that its minimal invasiveness improves patients' quality of life.
authors.affiliation: Department of Surgery (Omori), Toho University School of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-0015, Japan. hironori@med.toho-u.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yajima
authors.forename: Teruaki
authors.initials: T
authors.lastname: Minagawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D011788:Quality of Life