Laparoscopic Versus Open Hepatectomy For Benign And Malignant Neoplasm:a Retrospective Study

Objective:The laparoscopic hepatectomy, after being successfully applied in liver resection by Reich and his partners for the first time in1991, has been used widely in liver surg ery nowadays. It has also become an important alternative to open surgery in the treat ment of benign and malignant of the liver. This study will review107cases of laparos copic hepatectomy and open hepatectomy, aiming to illustrate that compared with ope n hepatectomy, evaluating the safety and feasibility of laparoscopic hepatectomy, and the advantages and disadvantages compared with traditional open surgery.Methods:According to the inclusion criteria and exclusion criteria of this article, retrospectively, I am going to analyse the data from107cases of liver surgery for benign and malignant tumors from March2007to December2013in Qilu Hospital of Shandong University. There is one group containing52patients who had received laparoscopic hepatectomy (LH) and another group containing55who had received open hepatectomy (OH). And the two groups are going to be compared in the aspects of operative time, intraoperative blood loss, blood transfusion, blocking the hepatic portal, indwelling stomach tube time, indwelling drainage tube time, postoperative hospital stay, hospital costs, postoperative complications and postoperative liver function changes.Results: Comparing LH group to OH group, it can be found that intraoperative blood loss, blood transfusion, blocking the hepatic portal, indwelling stomach tube time, indwelling drainage tube time, postoperative hospital stay, postoperative liver function (ALT, AST, Albumin levels) changes less in LH group, which has the statistical significance (P<0.05),whereas the hospitalization costs of LH group were higher than OH group, which also has the statistical significance (P<0.01). Although operation time in LH group is higher than that in OH group, it has no statistical significance(P>0.05), as so as postoperative survival. In LH group, there were one case of hepatic encephalopathy, one case of ascites, two cases of effusion occuring around the liver; and in OH group, there were one case of postoperative bleeding, one case of bile leakage, two cases of effusion occuring around the liver, one case of ascites, one case of pleural effusion. No death case were found in both groups during the intraoperative period and postoperative hospital stay.Conclusion:Both Laparoscopic hepatectomy and open hepatectomy have good therapeutic effect on treating benign and malignant liver tumors, but the former one has more advantages, because it has smaller abdominal incision, body trauma, faster postoperative recovery, shorter hospital stay,etc. Thus, laparoscopic hepatectomy for benign and malignant liver tumors is effective, minimally invasive, safe and feasible with the right patients and a complete preoperative evaluation.