Original CommunicationFeasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location
Section snippets
Indications for liver resection
The indications for laparoscopic liver resection were similar to open liver resection in terms of the preoperative assessment of liver function, type of liver resection, and postoperative care. In contrast, tumors larger than 5cm and tumors invading or adjacent to the main portal pedicle or inferior vena cava, as well as central lesions in the suprahepatic junction adjacent to major hepatic vein, were not considered for a laparoscopic approach. Tumors larger than 5cm are contraindicated for
Reasons for the conversion
During the laparoscopic liver resection for tumors in 82 patients, conversion to an open hepatectomy was necessary in 4 patients (5%). All 4 conversions occurred in cirrhotic patients, including 3 in group PS and 1 in group AL (P = .200). The reasons for conversion were bleeding (n = 1) and a positive gross resection margin (n = 2) in group PS, and poor localization of the HCC (n = 1) in group AL. One conversion occurred because of bleeding from a large branch of the portal vein during a right
Discussion
Despite increasing experience with laparoscopy and hepatic surgery, laparoscopic liver resection is limited to patients with the tumor localized in the anterolateral segments of the liver. The disadvantages of laparoscopic liver resections compared to open liver resection are poor visualization of posterior lesions and difficulty in bleeding control, especially for tumors in the posterosuperior part of the liver.10 Therefore, laparoscopic resections of lesions located in the posterosuperior
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