title: How Far Can We Go with Laparoscopic Liver Resection for Hepatocellular Carcinoma? Laparoscopic Sectionectomy of the Liver Combined with the Resection of the Major Hepatic Vein Main Trunk.
abstract: Although the reports of laparoscopic major liver resection are increasing, hepatocellular carcinomas (HCCs) close to the liver hilum and/or major hepatic veins are still considered contraindications. There is virtually no report of laparoscopic liver resection (LLR) for HCC which involves the main trunk of major hepatic veins. We present our method for the procedure. We experienced 6 cases: 3 right anterior, 2 left medial, and 1 right posterior extended sectionectomies with major hepatic vein resection; tumor sizes are within 40-75 (median: 60) mm. The operating time, intraoperative blood loss, and postoperative hospital stay are within 341-603 (median: 434) min, 100-750 (300) ml, and 8-44 (18) days. There was no mortality and 1 patient developed postoperative pleural effusion. For these procedures, we propose that the steps listed below are useful, taking advantages of the laparoscopy-specific view. (1) The Glissonian pedicle of the section is encircled and clamped. (2) Liver transection on the ischemic line is performed in the caudal to cranial direction. (3) During transection, the clamped Glissonian pedicle and the peripheral part of hepatic vein are divided. (4) The root of hepatic vein is divided in the good view from caudal and dorsal direction.
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Zenichi
authors.initials: Z
authors.lastname: Morise
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Kawabe
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tomishige
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nagata
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Kawase
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Arakawa
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine Banbuntane Houtokukai Hospital, 3-6-10 Otobashi Nakagawa-ku, Nagoya, Aichi 454-8509, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Isetani
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D006498:Hepatectomy / Q000379:methods; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*