Lymphovascular tumor embolus might be a risk factor for peritoneal metastasis after laparoscopic hepatectomy for hepatocellular carcinoma

Laparoscopic hepatectomy has been applied to treat hepatocellular carcinoma (HCC) (1-7). Previous reports show that laparoscopic procedure is as safe as the open procedure, and the long-term results are also inspiring. However, there are still doubts about whether laparoscopic procedure would increase the possibility of peritoneal metastasis and what the risk factors may be. This issue has not been found or mentioned in these recent reports. However, we here present two patients with HCC who developed peritoneal metastasis after laparoscopic hepatectomy. Risk factors for peritoneal metastasis after laparoscopic hepatectomy merits further study.