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Article: Determining resectability for hepatocellular carcinoma: The role of laparoscopy and laparoscopic ultrasonography

TitleDetermining resectability for hepatocellular carcinoma: The role of laparoscopy and laparoscopic ultrasonography
Authors
KeywordsLaparoscopic ultrasonography
Liver cancer
Resectability
Issue Date2000
PublisherSpringer Japan. The Journal's web site is located at http://link.springer.de/link/service/journals/00534/index.htm
Citation
Journal Of Hepato-Biliary-Pancreatic Surgery, 2000, v. 7 n. 3, p. 260-264 How to Cite?
AbstractWe reviewed our experience with preoperative determination of resectability in patients with hepatocellular carcinoma (HCC) over the last 10 years, and evaluated the role of laparoscopy with laparoscopic ultrasonography (USG) since we instituted this technique in June 1994. From January 1989 to December 1998, 500 of 1741 patients with HCC (28.7%) were considered suitable for hepatic resection after preoperative assessment. Significantly more contrast-enhanced computed tomography (CT) scans and fewer percutaneous USGs or hepatic arteriograms were performed in the 299 patients managed since June 1994 (group 2) than in the 201 patients managed before then (group 1). One hundred and ninety-eight patients in group 2 (66%) underwent laparoscopy with laparoscopic USG. Unresectable disease was found in 41 patients in group 1 (20.4%) (all at laparotomy), and in 68 patients in group 2 (22.7%) (16 at laparotomy without laparoscopic examination, 31 at laparoscopic examination alone, and 21 at laparotomy after an inconclusive laparoscopic examination) (P = 0.5). The most common features of unresectable disease were the presence of bilobar intrahepatic metastases and an inadequate liver remnant with cirrhosis. The adoption of the laparoscopic examination after June 1994 improved the overall resection rate at laparotomy in group 2 from 77.3% to 86.2%, which was better than that in group 1 (79.6%, P = 0.057). For patients with unresectable disease, the operation time and hospital stay were significantly shorter in group 2. The postoperative morbidity and mortality rates were 9.8% and 4.9%, respectively, in group 1, and 5.9% and 2.9% in group 2. There was no operative morbidity in the 31 patients who had unresectable disease detected by the laparoscopic examination alone. Laparoscopy with laparoscopic USG avoids unnecessary laparotomy, and has a definite role in determining resectability in patients with HCC.
Persistent Identifierhttp://hdl.handle.net/10722/83309
ISSN
2023 SCImago Journal Rankings: 1.104
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorYuen, WKen_HK
dc.contributor.authorYeung, Cen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:39:29Z-
dc.date.available2010-09-06T08:39:29Z-
dc.date.issued2000en_HK
dc.identifier.citationJournal Of Hepato-Biliary-Pancreatic Surgery, 2000, v. 7 n. 3, p. 260-264en_HK
dc.identifier.issn0944-1166en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83309-
dc.description.abstractWe reviewed our experience with preoperative determination of resectability in patients with hepatocellular carcinoma (HCC) over the last 10 years, and evaluated the role of laparoscopy with laparoscopic ultrasonography (USG) since we instituted this technique in June 1994. From January 1989 to December 1998, 500 of 1741 patients with HCC (28.7%) were considered suitable for hepatic resection after preoperative assessment. Significantly more contrast-enhanced computed tomography (CT) scans and fewer percutaneous USGs or hepatic arteriograms were performed in the 299 patients managed since June 1994 (group 2) than in the 201 patients managed before then (group 1). One hundred and ninety-eight patients in group 2 (66%) underwent laparoscopy with laparoscopic USG. Unresectable disease was found in 41 patients in group 1 (20.4%) (all at laparotomy), and in 68 patients in group 2 (22.7%) (16 at laparotomy without laparoscopic examination, 31 at laparoscopic examination alone, and 21 at laparotomy after an inconclusive laparoscopic examination) (P = 0.5). The most common features of unresectable disease were the presence of bilobar intrahepatic metastases and an inadequate liver remnant with cirrhosis. The adoption of the laparoscopic examination after June 1994 improved the overall resection rate at laparotomy in group 2 from 77.3% to 86.2%, which was better than that in group 1 (79.6%, P = 0.057). For patients with unresectable disease, the operation time and hospital stay were significantly shorter in group 2. The postoperative morbidity and mortality rates were 9.8% and 4.9%, respectively, in group 1, and 5.9% and 2.9% in group 2. There was no operative morbidity in the 31 patients who had unresectable disease detected by the laparoscopic examination alone. Laparoscopy with laparoscopic USG avoids unnecessary laparotomy, and has a definite role in determining resectability in patients with HCC.en_HK
dc.languageengen_HK
dc.publisherSpringer Japan. The Journal's web site is located at http://link.springer.de/link/service/journals/00534/index.htmen_HK
dc.relation.ispartofJournal of Hepato-Biliary-Pancreatic Surgeryen_HK
dc.subjectLaparoscopic ultrasonographyen_HK
dc.subjectLiver canceren_HK
dc.subjectResectabilityen_HK
dc.titleDetermining resectability for hepatocellular carcinoma: The role of laparoscopy and laparoscopic ultrasonographyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0944-1166&volume=7&spage=260&epage=264&date=2000&atitle=Determining+resectability+for+hepatocellular+carcinoma:+the+role+of+laparoscopy+and+laparoscopic+ultrasonographyen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10982624en_HK
dc.identifier.scopuseid_2-s2.0-0033648462en_HK
dc.identifier.hkuros52453en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033648462&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume7en_HK
dc.identifier.issue3en_HK
dc.identifier.spage260en_HK
dc.identifier.epage264en_HK
dc.publisher.placeJapanen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK
dc.identifier.scopusauthoridYeung, C=26531966700en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.issnl0944-1166-

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