Advanced hepatocellular carcinoma with portal tumor thrombosis in cirrhotic patient: laparoscopic right hepatectomy with vascular reconstruction

Hepatocellular carcinoma (HCC) is the commonest hepatic malignancy and is frequently associated with cirrhosis and vascular involvement. Liver resection (LR) is a potentially curative treatment to HCC, but is a challenging task in cirrhotic patients especially with tumor vascular invasion. The laparoscopic approach is associated with lower morbidity rates in cirrhotic patients, but is rarely reported in cases of involvement of the portal vein. We report a laparoscopic right hepatectomy with portal vein reconstruction in a cirrhotic HCC patient with advanced portal vein tumor thrombosis. This is a potentially curative and complex procedure that can be an effective technique in highly selected patients that usually would be considered only for palliative systemic treatment.