Redo Laparoscopic Segment 2/3 Hepatocellular Carcinoma Resection in Alcohol-Related Chronic Liver Disease

Purpose: Hepatocellular Carcinoma is a leading cause of death in chronic liver disease and cirrhosis. Operative treatment options include surgical resection or liver transplantation. Minimally invasive approaches reduce patient morbidity and improve recovery and return to normal activity, but can be an operative challenge in fibrotic, cirrhotic liver parenchyma. Method: 72-year-old male presented with Hepatocellular Carcinoma in segment 2/3 on a background of alcohol-related Chronic Liver Disease. Multidisciplinary decision to proceed to Laparoscopic Non-anatomical Liver resection. Histology demonstrated mixed HCC, R0 resection with microvascular invasion present. 8/12 follow updemonstrated recurrence in left lateral segments 2/3. Multidisciplinary decision to proceed to Laparoscopic redo Liver resection of segment 2/3 Results: Laparoscopic non-anatomical resection of Segment 2/3 HCC was performed. Histology demonstrated HCC, R0 resection. The patient made an uncomplicated recovery and remains disease free at 4 years. Conclusion: Laparoscopic re-do liver resection for HCC with background chronic liver disease is a feasible and safe approach in selected cases. Careful haemostasis during laparoscopic dissection in cirrhosis is key to avoid intraoperative bleeding, and minimise the risk of losing the visual field and converting to open surgery.