Laparoscopic Liver Resection for Hepatocellular Carcinoma Associated with Hepatic Glycogen Storage Disease—A Case Report—

Abstract

A 68-year-old woman was diagnosed with hepatic glycogen storage disease at the age of 59 years and was started on nutritional therapy with complementary foods. Examination of her persistent liver damage showed hepatocellular carcinoma in liver S8 (23 mm in size) and S3 (10 mm in size), and she was referred to our department for surgical treatment. The S8 lesion was localized on the liver surface, whereas the S3 lesion was located deep in the liver and close to Glisson's pedicle of S3. Considering that surgical stress is a risk factor for the development of lactic acidosis and hypoglycemia due to glycogen storage disease, laparoscopic partial resection for the S8 lesion and radiofrequency ablation for the S3 lesion were performed. During perioperative management, blood glucose levels were frequently measured, and the amount of supplementary food was adjusted to prevent hypoglycemia and lactic acidosis, which are complications specific to glycogen storage disease. Thorough perioperative management was successful, and she was discharged on the 13th postoperative day without any adverse events. For patients with glycogen storage disease, a careful perioperative treatment strategy that enables the selection of less invasive surgical techniques and the management of perioperative blood sugar and lactic acid levels is essential.