Laparoscopic Versus Open Hepatectomy For Benign And Malignant Neoplasm Located In The Right Hemiliver: A Comparative Study

Objective:After being successfully applied in liver resection by Reich and his partners for the first time in 1991, laparoscopic hepatectomy has been used widely in liver surgery nowadays. Presently, laparoscopic hepatic left lateral sectionectomy has become a routine treating method, but treatment of lesions located in the right hemiliver under laparoscope are still regarded as high-risk technique with great difficulty in manipulating. This study reviewed 74 cases who accepted laparoscopic hepatectomy and open hepatectomy for the treatment of benign and malignant neoplasm located in the right lobe of the liver, aiming to evaluate the safety and feasibility of laparoscopic hepatectomy comparing with open hepatectomy, assess the advantages and disadvantages between them.Methods:According to the inclusion criteria and exclusion criteria of this retrospective research, data of 74 cases of liver surgery for the treatment of benign and malignant tumors from January 2010 to March 2015 in Qilu Hospital of Shandong University were collected. One group contain 35 patients who had received laparoscopic hepatectomy (LH group) and the other group contain 39 cases who had received open hepatectomy (OH group). These two groups were analyzed compared in the aspects of operative time, intraoperative blood loss, blood transfusion, blocking of the hepatic portal, indwelling nasogastric tube time, indwelling abdominal drainage tube time, postoperative hospital stay, liver function changes and postoperative complications.Results:Comparing LH group to OH group, it can be found that intraoperative blood loss, blood transfusion, and operating time have no statistical difference(P>0.05). Indwelling nasogastric tube time, indwelling abdominal drainage tube time and postoperative hospital stay changes less in LH group, with statistical difference (P <0.05). As to hepatic portal blockage, although the blocking time is longer in LH group, lesser percentage of portal blockage were needed in LH group compared with OH group, both have the statistical difference (P<0.05). And postoperative liver function were significantly better in LH group compared with OH group. 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 and security on treating benign and malignant tumors located in right hemiliver, but the former one has more advantages, for it has smaller abdominal incision, less body trauma, faster postoperative recovery and shorter hospital staying, etc. Thus, under thorough preoperotive assessment and appropriate case choice, benign and malignant liver tumors located in the right hemiliver can be a suitable indication for laparoscopic hepatectomy, and this therapy can be effective, minimally invasive, safe and feasible.