The laparoscopic hepatectomy for ruptured hepatocellular carcinoma controlled after transcatheter arterial embolization

We report a case of the laparoscopic hepatectomy for ruptured hepatocellular carcinoma (HCC) controlled after transcatheter arterial embolization (TAE). The patient was 70 year-old-male who had underwent laparoscopy-assisted distal gastrectomy for early gastric cancer 7 years ago, and visited the emergency department because of shock. An abdominal CT scan revealed a ruptured tumor in S6 of liver. Emergency TAE achieved successfully hemostasis. Elective laparoscopic hepatectomy (LH) was performeded on day 40 after TAE. HALS was used to obtain the sufficient surgical margin and to release intra-abdominal adhesions safely. The liver parenchyma was transected using microwave tissue coagulator and salient monopolar sealer for precoagulation. The patient discharged from hospital at POD7 without morbidity. We suggest LH could be one of the options for staged hepatectomy of the ruptured HCC, in properly selected patients.