Comparison Between Laparoscopic And Open Liver Resection

Objective:Through the comparative analysis based on propensity score matching Analysis after Laparoscopic liver resection(LLR)and Open liver resection(OLR)differences on safety,efficacy,to explore the clinical application value of LLR,provides reference for the further development of LLRMethods:This study retrospectively analyzed all 395 patients who underwent the first liver resection in the department of hepatobiliary surgery of the first affiliated hospital of south China university from March 2015 to December 2018,including 164 patients in the laparoscopic liver resection group and 231 patients in the open liver resection group.Preoperative data including preoperative biochemical indexes,presence or lack of hepatitis,presence or lack of cirrhosis and basic information of the patients were used for 1:1 propensity matching of the cases,and the patients in the two groups were well balanced after the propensity score matching.Comparison of safety and efficacy between groups.Results:1.The comparison between preoperative: preoperative hemoglobin in the match before the LLR group was obviously higher than that of OLR group(P<0.05),significantly higher than the preoperative albumin OLR group(P<0.05),while additional operation ratio was lower than that in group OLR(P<0.05),has a history of abdominal surgery ratio was lower than that in group OLR(P<0.05),white blood cells was lower than that in group OLR preoperative(P<0.05),preoperative aspertate aminotransferase was lower than that in group OLR(P<0.05),preoperative PT was lower than that in group OLR(P<0.05).The two groups were well matched by propensity score,and the preoperative data showed no statistical difference(P>0.05),which was comparable.2.Intraoperative observation indexes: compared with OLR group,LLR group had less intraoperative blood loss(P<0.05)and longer operation time(P<0.05),with statistical difference between the two groups.There was no significant difference in the number of intraoperative blood transfusion cases between the two groups(P>0.05).3.Postoperative observation indexes: 1)laboratory indexes: compared with OLR group,LLR group had higher albumin on day 1,4 and 7 after surgery(P<0.05),while white blood cells,alanine transaminase and cereal grass transaminase were lower on day 1,4 and 7 after surgery(P<0.05).2)postoperative clinical observation indexes: compared with OLR group,LLR group had shorter postoperative hospitalization days,anal exhaust time,drainage tube extraction time and feeding time(P<0.05).3)comparison of postoperative complications: compared with OLR group,LLR group has a lower incidence of postoperative complications(P<0.05),and there is a statistical difference between the two groups,while there is no significant difference between the two groups in different types of complications.Conclusion:LLR can effectively reduce the amount of intraoperative blood loss,reduce the incidence of complications,promote the recovery of gastrointestinal function,and shorten the length of hospital stay,which further confirms the safety and effectiveness of LLR.Compared with OLR,LLR has obvious advantages.