부산대학교 도서관

We report a case of spontaneously hemostatic ruptured hepatocellular carcinoma(HCC)resected laparoscopically. A 61-year-old previously healthy woman was admitted to our hospital with complaint of mild pain related to the tumor in the upper abdomen. She had no viral infection. Abdominal ultrasound, computed tomography, and MRI revealed a protrusive liver tumor arising from segment Ⅲ about 5.7cm in maximal diameter, which was increasing. Alfa-fetoprotein and protein induced by vitamin K absence or antagonist Ⅱ were extremely high and increasing rapidly. HCC was suspected and laparoscopic left lateral segmentectomy was performed. A little bloody ascites was present and ruptured HCC was suspected. The tumor was covered with a part of lesser omentum and pancreas, and the bleeding site had been sealed off. We could finish the laparoscopic operation safely because vital signs were stable. Postoperative course was uneventful. A few cases with ruptured HCC have been seen treated by laparoscopic hepatectomy alone in the literature. When the tumor bleeding is completely controlled and general conditions are stable, one-stage laparoscopic liver resection is one of the options.