肝硬変合併肝細胞癌に対する腹腔鏡補助下肝切除術

概要

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Nine cirrhotic patients with liver tumors underwent a gasless laparoscopic hepatic resection with a 5 cm minilaparotomy. To maintain the good visualization and working space during hepatic resections, we developed a simple retraction system. Tumors located in segment II through VI of the liver could be treated by the laparoscopic procedure. In three of the nine patients, laparoscopic microwave coagulation therapy was added for each HCC tumors that were detected by intraoperative sonography. No blood transfusion was necessary during the operations. No serious complications such as air embolism occurred. The procedure was also applicable to cirrhotic patients with some complications. The good indication of the laparoscopic procedure is for the patients with small HCCs associated with liver cirrhosis, who are not candidates for radical hepatic resection.