Kết quả 05 năm phẫu thuật nội soi cắt gan lớn điều trị ung thư biểu mô tế bào gan tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: Laparoscopic surgery has continuously evolved and is gradually replacing conventional open surgery in most abdominal procedures. However, for liver surgery, the rate of open surgery remains relatively high, especially in major hepatectomies. This study aims to evaluate the outcomes of laparoscopic major hepatectomies for hepatocellular carcinoma (HCC) over a five-year period. Subject and method: A retrospective study was conducted on HCC patients who underwent laparoscopic major hepatectomy at the Department of Hepato-Pancreato-Biliary Surgery, 108 Military Central Hospital, from January 2019 to December 2023. Result: A total of 94 cases of laparoscopic major hepatectomy for HCC were performed. The most common procedures were left hepatectomy (74.5%). The average operative time was 202.26 ± 89.16 minutes, with a mean blood loss of 257.38 ± 123.84mL. The conversion rate to open surgery was 10.4%, while intraoperative complications occurred in 9.6% of cases. Overall postoperative complication rates were 13.8%. The average hospital stay was 8.08 ± 2.35 days, with a readmission rate of 2.1%. The mortality and reoperation rates were both 1.1%. Regarding long-term outcomes, the overall survival time was 50.66 ± 2.58 months, while disease-free survival was 42.88 ± 2.80 months. Conclusion: Laparoscopic major hepatectomy for HCC is a safe and feasible approach. It is minimally invasive, facilitates faster recovery, and provides favorable long-term outcomes. With appropriate patient selection, laparoscopic major hepatectomy could become the gold standard for HCC.