Minimally invasive liver surgery for hepatocellular carcinoma in patients with portal hypertension
Keywords: 
Materias Investigacion::Ciencias de la Salud::Cirugía
Materias Investigacion::Ciencias de la Salud
Materias Investigacion::Ciencias de la Salud::Medicina preventiva
Issue Date: 
2023
Publisher: 
Oxford University Press
ISSN: 
2474-9842
Note: 
This is an Open Access article distributed under the terms of the Creative Commons Attribution License
Citation: 
Aliseda, D. (Daniel); Zozaya-Larequi, G. (Gabriel); Marti-Cruchaga, P. (Pablo); et al. "Minimally invasive liver surgery for hepatocellular carcinoma in patients with portal hypertension". British Journal of Surgery. 7 (2), 2023,
Abstract
For patients with early stage hepatocellular carcinoma (HCC), liver resection is a mainstay of curative treatment. Patients with a solitary tumour, Child–Pugh A cirrhosis and serum bilirubin of 1 mg/dl are considered ideal candidates for liver resection1,2 . For patients with portal hypertension, current guidelines recommend careful consideration of liver resection based on the hierarchical interaction of portal hypertension, liver function and resection extent1,3 . Open liver resection has been used in the majority of published studies on liver resection and portal hypertension. Although there is limited published experience of minimally invasive liver resection (MILR), using MILR in these patients appears to be associated with favourable outcomes4 . Particularly in patients with Child–Pugh A cirrhosis, but also in patients with more advanced cirrhosis5 , MILR offers significant advantages in the surgical treatment of HCC including reduced intraoperative bleeding, fewer complications and minimized surgical aggression, which improves recovery6,7 . If these benefits are also found in patients with portal hypertension, MILR may represent a step forward in the surgical treatment of patients with HCC and portal hypertension. This systematic review and meta-analysis aimed to summarize the intraoperative, postoperative and survival outcomes of MILR in patients with HCC and portal hypertension.

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