Background : Laparoscopic liver resection has become a standard procedure for hepatocellular carcinoma (HCC) in many centers. Nevertheless, laparoscopic liver resection for HCC located in posterosuperior segments is demanding procedure even experienced hepatobiliary surgeons. We compared the outcomes between laparoscopic liver resection for HCC located in posterosuperior segments (S7, S8) and anterolateral segments (S5, S6).

Methods : We performed a retrospective analysis for 279 patients who received laparoscopic liver resection (except left hepatectomy) for HCC from September 2014 to December 2021 in Kyungpook National University Hospital. Patients were classified two groups, posterosuperior group (n=170 ) and anterolateral group (n=109 ).

Results : There were no differences in preoperative patients characteristics between two groups. Distribution of resection type (anatomical vs non-anatomical resection) was no significant differences between two groups. Operation time and intraoperative transfusion were greater in posterolateral group. Postoperative complication rate, hospital stay and oncologic outcomes (pathologic report, overall survival and disease free survival) were not significantly different between two groups. We had no open conversion case in posterolateral group.

Conclusions : With increased experience for major hepatectomy and the advance of laparoscopic instruments, laparoscopic liver resection for HCC located in posterosuperior segments is safe and feasible surgical procedure compared to anterolateral segments resection. Tumor status and anatomical variation of liver must be considered for oncologic safety.