Value of the Laparoscopic Approach in the Surgical Management of Resectable Hepatocellular Carcinoma

Value of the Laparoscopic Approach in the Surgical Management of Resectable Hepatocellular Carcinoma: a Randomized Controlled Trial

Hepatocellular carcinoma treated by laparotomy or laparoscopic Multicenter prospective, open, superiority, controlled, randomized, clinical trial The primary objective of the study will be to demonstrate the superiority of the laparoscopic approach over the open approach in reducing postoperative morbidity in HCC patients.

Postoperative morbidity will be assessed using the Comprehensive Complication Index (CCI) within 90 days postoperatively or at any time during hospitalization

Inclusion Criteria:

• Male or female patient aged ≥ 18 years
• Presenting with solitary or multifocal resectable HCC
• Qualifying for both pure laparoscopic and open approaches

Exclusion Criteria:

• Physical or psychological status contraindicating the participation to the study
• Contraindication to surgery
• Contraindication to pneumoperitoneum
• ASA (American Society of Anesthesiologists) score IV-V
• Life expectancy < 2 months
• Suspicion of mixed type tumor (Hepatocholangiocarcinoma) and fibrolamellar HCC
• Child-Pugh score > B7
• Extra-hepatic involvement
• Liver resection requiring an associated vascular or biliary reconstruction
• Pregnancy and breast-feeding
• Tutorship, trusteeship
• Concurrent participation in other experimental trials concerning the same objective within 90 days following intervention
• No Affiliation to the French social security
• No Ability to give their consent and not written informed consent