Comparison Of Laparoscopic Versus Open Hepatectomy In Short-term Outcome And Hospitalization Expenses

Objective:After more than 20 years,the application of Laparoscopichepatectomy(LH)becomes mature,gradually from the edge of liver excision to theresection of anatomical liver segment,lobe and half liver.This paper explores thesafety,feasibility,minimally invasion and social value of LH by comparison of LH with open hepatectomy(OH)in short-term outcome and hospitalization cost,andfinds some typeswhich are suitable for laparoscopic liver resectionthrough several subgroups analysis.Methods:This retrospective study enrolled patients with hepatectomy between January 2010 and September 2014.According to the surgery methods,the patients were dibided into LH group and OH group.The operation,postoperative recovery,hospitalization cost were compared between two groups.Five subgroup analysis of patients who were respectively diagnosed ashepatocirrhosis,tumor of liver,hepatolithiasis,suffered from reoperation,resection of segments II-III.Results:A total of 142 cases,73 cases of male,the female of 69 cases,aged 21 to 80 years old,and the average age was 54.90 years.A total of 142 cases were in this paper.66 patients of LH and 76 patients of OH were included.All the hepatic resection operations were successful.There were no significant difrerence in preoperative data between two group with respect to sex,age,BMI index,ASA status,Child-Pugh status,preoperative coexistent diseases and location of the liver.The LH group was associated with shorter operation time(151.71 ±64.81 vs.206.45±69.02 min,P<0.01),less blood loss(111.82±87.56 vs.307.89±236.37ml,P<0.01),compared with OH group.And the LH group was also superiorto the OH group in feeding time(2.33±0.69 vs.3.96± 1.01d,P<0.01),post-operative hospital stays(7.21 ± 3.42 vs.13.72±9.16 d,P<0.01),complications were also lesser and milder(9.09%vs.26.32%P<0.01),hospitalize-tion expenses(41041.67±14005.19 vs.48251.84±23266.53 cny,P=0.03).Compared ALT,ALB,TBIL,WBC and HsCRP of LH group with OH group at 1-3-,5-day,it is statistically significance different of Volatility and recovery(P<0.05).In subgroups of Tumor,Hepatolithiasis,Segment Ⅱ-Ⅲ,obvious differences were found between Operation time,intraoperative blood loss,postoperative recovery and hospitalization expenses,LH groups of advantage was clear(P<0.05).And in Liver cirrhosis and Reoperation subgroups,this advantage was not obvious than other three subgroups.The two subgroups in operation time,feeding time,complications and hospitalization expenses were no statistical difference(P>0.05).Conclusions:Laparoscopic hepatectomyis safe and feasible,such as shorter operation time,less intraoperative blood loss,postoperative recovery quickly and low hospitalization cost.It’s particularly applicable to the resection of tumor,hepatolithiasis,segment Ⅱ-Ⅲ.