Role of Laparoscopy in Changing the Management of Hepatocellular CarcinomaMohamed Ismail Seleem*, Mohamed Hassany, Hossam E El Shafey and Mohamed S Abdelwahed
Department of Hepato-biliary Surgery and Tropical Medicine, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
- *Corresponding Author:
- Dr. Mohamed Ismail Seleem
Department of Hepatobiliary Surgery and Tropical Medicine
National Hepatology and Tropical Medicine Research Institute
Nasr City, Cairo, Egypt
E-mail: [email protected]
Received date: September 11, 2013; Accepted date: October 15, 2013; Published date: October 20, 2013
Citation: Seleem MI, Hassany M, Shafey HEE, Abdelwahed MS (2013) Role of Laparoscopy in Changing the Management of Hepatocellular Carcinoma. J Gastroint Dig Syst 3:147. doi: 10.4172/2161-069X.1000147
Copyright: © 2013 Seleem MI, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Laparoscopic approach offers the advantages of intra-operative laparoscopic ultrasonography (IOLUS), which provides better resolution of the number and location of liver tumors, and liver condition. In recent years the progress of laparoscopic procedures and the development of new and dedicated technologies have made laparoscopic hepatic surgery feasible and safe. The aim of this study is to present the results of our experience in laparoscopic management of Hepatocellular carcinoma (HCC) in cirrhotic patients.
Patients and methods: Between September 2010 and January 2013, Four hundred patients with HCC in liver cirrhosis were referred from HCC clinic at National Hepatology and Tropical Medicine Research Institute (NHTMRI). 65 patients were submitted to diagnostic laparoscopy. 33 patients had Laparoscopic Radiofrequency Ablation with IOLUS guidance and 14 patients had laparoscopic non-anatomical resection while 18 patients had been converted to open laparotomy. Operation time, hospital stay, post-procedure complications were recorded. Spiral CT scan one month postoperative was mandatory during follow up.
Results: Laparoscopic management was completed in 47 patients. The IOLUS examination identified new HCC in three patients. A total of 50 lesions were treated laparoscopically. The mean operative time was 120 ± 50 minutes; eight procedures were associated in six patients: cholecystectomy (6) and adhesiolysis (2). A complete tumor ablation was observed in treated patients by LRFA which were documented via spiral computed tomography (CT scan) one month after treatment. In resection group, histopathology was confirmed that, all tumor resection were with safety margin.
Conclusion: Laparoscopic procedure proved to have a role in changing the management of HCC either by resection or by LRFA. Laparoscopy proved to be a safe and effective technique.