Prospective Randomized Trial of Laparoscopic Versus Open Liver Resection for HCC

Prospective Randomized Trial of Laparoscopic Versus Open Liver Resection for Patients With Hepatocellular Carcinoma

Short-term outcomes of laparoscopic liver resection is better than those of open liver resection

Laparoscopic liver resection is better than open resection in immunological aspects

Advantages and disadvantages of the laparoscopic compared with the open approach for liver resections

1. Advantages 1) Less postoperative ascites production 2) Reduced postoperative pain 3) Feasible in selected cirrhotics who have contraindications to open surgery 4) Less intra-abdominal adhesions (easier salvage transplantation) 5) Shorter recovery time 6) Shorter length of stay 7) Reduced financial cost
2. Disadvantages 1) No manual palpation or exploration of the liver parenchyma possible (with the pure laparoscopic approach) 2) High demand in surgical skill (especially major resections)

Inclusion Criteria:

• Radiologically diagnosed hepatocellular carcinoma
• Child classification A or B
• Aged 20 to 80
• Informed consent taken

Exclusion Criteria:

• Child classification C
• Extrahepatic metastasis
• Tumor located in central area or adjacent to middle hepatic vein
• Recurred hepatocellular carcinoma
• Critically ill patient
• Patient with psychiatric disease