Comparison Of Efficacy Between Laparoscopic Hepatectomy And Open Hepatectomy For Primary Hepatocellular Carcinoma

Objective: To compare laparoscopic hepatectomy with open hepatectomy in the surgical treatment of hepatocellular carcinoma(HCC),the feasibility,safety and short-term and long-term effects in the treatment of hepatocellular carcinoma were discussed.Materials and methods: Check out the cases of hepatocellular carcinoma treated surgically in our hospital from January 2010 to January 2017.According to the inclusion and exclusion criteria,27 patients were enrolled in the laparoscopic liver resection group and 30 patients with open liver resection.The data of the two groups of patients were collected.The postoperative complications,postoperative recurrence rate,mortality rate and survival rate were collected.Results: The sex,age,liver function grade and AFP level,hepatitis B surface antigen positive rate in liver cirrhosis,maximum diameter and anatomical location of liver cancer focus were compared between the two groups,there was no significant difference between the two groups(P>0.05),and had good consistency of preoperative data between the two groups.The patients in both groups had successfully completed the operation,no death during operation.There was no significant difference in the mean intraoperative bleeding volume,the number of cases of intraoperative blood transfusion and the mean operative time between the two groups(P>0.05).The levels of TBIL and alt in LH group were lower than those in OH group on the third day after operation(P<0.05).The level of albumin in the reaction liver synthesis function was higher than that in the OH group,and there was no significant differencebetween the two groups(P>0.05).There was no significant difference between the two groups in postoperative complications such as postoperative secondary hemorrhage,bile leakage of capillary bile duct,abdominal cavity infection,incision infection,pulmonary infection,abdominal effusion,incision fat liquefaction and pleural effusion(P>0.05).The duration of fasting water and the days of indwelling drainage in LH group were lower than those in OH group(P<0.05).The cost of operation in LH group was significantly higher than that in OH group(P<0.05),and the total cost of hospitalization in LH group was higher than that in OH group,but there was no significant difference between LH group and OH group(P>0.05).The postoperative hospital days and total hospitalization days in LH group were lower than those in OH group(P<0.05).There was no significant difference in recurrence rate,mortality rate and 1 year survival rate between the two groups after 1 years of follow-up(P>0.05).Conclusion: In the surgical treatment of hepatocellular carcinoma,laparoscopic hepatectomy is a safe,feasible and effective surgical method.Compared with open hepatectomy,laparoscopic hepatectomy has the advantages of small incision,low trauma,small systemic stress response and short hospital stay.The incidence of postoperative complications is low,and can achieve the same therapeutic effect.Although the operation is difficult,it has a good prospect in the surgical treatment of hepatocellular carcinoma.