Objective：To study the safety, feasibility and minimal invasiveness of laparoscopic hepatectomy for primary liver cancer.
Methods：The clinical data of 32 patients with primary liver cancer undergoing laparoscopic hepatectomy from October 2008 to February 2011 were retrospectively analyzed.
Results：Laparoscopic hepatectomies were successfully performed in all patients without convertion to an open surgery. The lesions were located in Couinaud hepatic segment II (n=3), segment III (n=8), segments II and III (n=10), segment IV (n=2), segment V (n=4) and segment VI (n=5), respectively. All patients had a single lesion combined with liver cirrhosis and the lesion size ranged from 1.8 to 9.2 cm. The grades of liver function before operation was Child′s grade A (n=27) and Child′s grade B (n=5), respectively. The operative procedures consisted of left hemihepatectomy (n=2), left lateral lobectomy (n=15) and local resection (n=15), respectively. The liver parenchyma was transected by combining Laparoscopic ultrosonic scalpel with LigaSure or Endo-GIA. Two patients underwent hepatic inflow occlusion for 15 and 22 min, respectively, and 3 patients received 2 units of RBC transfusion. No postoperative complications such as bleeding, biliary leakage or liver failure occurred. All cases recovered and discharged. Three cases had local tumor relapse and no death occurred in the 32 patients during the follow-up period of 5-26 months.
Conclusions：Laparoscopic hepatectomy for primary liver cancer is safe and feasible. Indications of laparoscopic hepatectomy for primary liver cancer should be strictly defined because the procedure has high technical difficulty. The size and location of the hepatic lesions are the major selective indicators. The combination of ultrosonic scalpel and LigaSure for liver transection has the advantages of good hemostatic effect and clear anatomy.