title: Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: report of a case.
abstract: Hepatocellular carcinoma accompanied by portal hypertension and hypersplenism is difficult to treat medically and surgically due to pancytopenia and the development of collateral circulation. In this study, we were able to safely and simultaneously perform a laparoscopically-assisted splenectomy and partial hepatectomy. The characteristics of this procedure include: (1) the shared use of a medial wound made through laparoscopically-assisted surgery; (2) improved safety for manipulating areas that were difficult to observe with a camera in a case of splenomegaly; (3) a preventive ligation of the splenic artery; (4) improved hemostatic function using LigaSure Impact; and (5) hemorrhage control through manual manipulations and the Pringle maneuver during liver parenchymal transection. The surgery was safely performed using the above points.
authors.affiliation: Department of Surgery, Goto Central Hospital, 205 Yoshikugi, Goto, Nagasaki, 853-0031, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohno
authors.forename: Junichiro
authors.initials: J
authors.lastname: Furui
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Hirabaru
authors.forename: Masaki
authors.initials: M
authors.lastname: Kohno
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Iwao
authors.forename: Jun
authors.initials: J
authors.lastname: Koyamatsu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D058733:Hand-Assisted Laparoscopy; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D006971:Hypersplenism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D013156:Splenectomy / Q000379:methods*