T. Cheung1, C. Lo1 1The University Of Hong Kong,Hong Kong, HONG KONG, Hong Kong
Introduction:
Bleeding in the presence of thrombocytopenia has been a major issue in liver resection even in open procedures. Although laparoscopic liver resection has been reported to be a safe and effective treatment even in patients with liver cirrhosis, there is very little evidence in patients with thrombocytopenia.
Methods:
Between October 2002 and February 2016, 132 patients had undergone pure laparoscopic liver resection for hepatocellular carcinoma (HCC). Thrombocytopenia was defined as platelet counts <100x 109/L. Amongst 132 patients received laparoscopic liver resection, 17 patients who had thrombocytopenia (Group 1) and 111 patients who did not have thrombocytopenia (Group 2) with the same solitary tumor and clear resection margin characteristics were chosen for comparison.
The immediate operation outcome and survival including operation morbidity were compared. The disease free survival and overall survival were also compared.
Results:
Comparing Group1 to Group 2, the median operation time was 184 minutes vs 175 minutes p=0.817, the median blood loss was 200ml vs 100ml (P=0.347). Hospital stay was 4 days vs 4 days (P<0.888), postoperative complication was 3(17.6%) vs 8(7.2%) (p=0.334), median disease free survival was 20 months vs 71 months (P<0.001) and the median overall survival was >120 months vs 136 months (P=0.298). The median disease free survival for stage II HCC was 12 months vs 71 months (p=0.001).
Conclusion:
Thrombocytopenia does not have an adverse effect immediately on laparoscopic liver resection. Long term outcome has to be evaluated further in future.