• Yo-ichi Yamashita, Tetsuo Ikeda, Takeshi Kurihara, Yoshihiro Yoshida, Kazuki Takeishi, Shinji Itoh, Norifumi Harimoto, Hirofumi Kawanaka, Ken Shirabe, and Yoshihiko Maehara.
• Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: yamashi@surg2.med.kyushu-u.ac.jp.
• J. Am. Coll. Surg.. 2014 Dec 1;219(6):1117-23.

BackgroundWe first performed laparoscopic hepatic resection (Lap-Hx) for hepatocellular carcinoma (HCC) in 1994. Here we review the long-term surgical results of Lap-Hx for HCC in patients with cirrhosis over a 10-year period at a single institution.Study DesignBetween January 2000 and December 2013, 99 patients with cirrhosis underwent open hepatic resection (Open-Hx) and 63 underwent Lap-Hx for primary HCC within the Milan criteria. We compared the operative outcomes and patient survival between the 2 groups.ResultsThere were no significant differences regarding patient background characteristics or tumor-related factors between the 2 groups. The morbidity rate of the Lap-Hx group was significantly lower than that of the Open-Hx group (26% vs 10%; p = 0.0459), and the complication rate of ascites was significantly lower (7% vs 0%; p = 0.0077). The mean duration of hospital stay of the Lap-Hx group was significantly shorter than that of the Open-Hx group (16 vs 10 days; p = 0.0008). There were no significant between-group differences regarding overall or disease-free survival.ConclusionsLaparoscopic-Hx for HCC in patients with cirrhosis is associated with less morbidity and shorter hospital stays, with no compromise in patient survival. It may be time to consider changing the standard operation for primary HCC within the Milan criteria to Lap-Hx in patients with cirrhosis.Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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