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Open liver resection, laparoscopic liver resection, and percutaneous thermal ablation for patients with solitary small hepatocellular carcinoma (≤30 mm): Review of the literature and proposal for a therapeutic strategy

Digestive Surgery Jun 17, 2018

Viganò L, et al. - Researchers sought to determine the most adequate treatment methods for patients with a single hepatocellular carcinoma (HCC) ≤3 cm and preserved liver function. On reviewing the literature about open anatomic resection (AR), laparoscopic liver resection (LLR), and percutaneous thermal ablation (PTA), it was suggested that laparoscopic limited resection is the standard for any subcapsular HCC. For deep-located HCC < 2 cm, PTA has emerged as the first-line treatment, except for those in contact with Glissonean pedicles. For deep-located HCC of 2–3 cm of the left liver Laparoscopic, AR is the standard, while for deep-located HCC of 2–3 cm in the right liver, open AR is the standard. Resection (open or laparoscopic) is recommended for HCC in contact with Glissonean pedicles irrespective of their size. They suggest reserving liver transplantation for otherwise untreatable patients or as a salvage procedure at recurrence.
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