Clinical Effect Comparasion Between Laparoscopic And Laparotomic Major Hepatectomy

Objective To explore the clinical effect difference between laparoscopic major hepatectomy(LMH)and laparotomic major hepatectomy.Methods A retrospective analysis of 35 cases that were conducted with LMH between 2016 and 2018 in the First Affiliated Hospital of Soochow University was performed.35 cases of laparotomic major hepatectomy were selected randomly as control group.The clinical data including age,gender,chronic diseases,operation mode,operation time,amount of bleeding,blood transfusion,preoperative and postoperative indicators,length of hospital stay,etc.was counted and compared.All data were statistically analyzed by SPSS 25.0 statistical software.Results There are 35 cases in laparoscopic group,the same as the laparotomy group.?DIn comparison of laparotomy group,the levels of age,gender,the distribution of chronic diseases and the Child-Pugh score showed no significant statistical difference(P>0.05),so the study was carried on.?In comparison of laparotomy group,the levels of blood loss and transfusion had no statistical significance(P>0.05),while the operation time of laparoscopic group was significantly longer(272.6±73.7min vs.200.5±50.6min,P<0.001).?In comparison of laparotomy group,the preoperative and the first-postoperative-day indicators including Hb?ALT?AST?T-Bil and ALB showed no statistical difference(P>0.05).When it comes to the third day the indicators including Hb,T-Bil and ALB still showed no significant statistical difference(P>0.05),while ALT(111.8±61.4 vs.168.7±153.2,t=2.06,P=0.04)and AST(87.4±75.3 vs.145.9±150.0,t=2.04,P=0.04)of laparoscopic group went down more obviously compared with laparotomy group.?In comparison of laparotomy group,the fasting time(2.44±1.16 Day vs.3.09±0.82 Day),drainage time(6.38±2.37 Day vs.8.00±3.04 Day)and the length of hospital stay(8.97±3.51 Day vs.11.06±3.93 Day)of laparoscopic group was much better(P<0.05).In terms of complications,compared with laparotomy group,there were fewer cases in laparoscopic group(?2=4.48,P=0.03).But there was no statistical significance between single complications(P>0.05).Conclusion Even though LMH is still to be developed and it takes more time to perform LMH.But we consider that LMH,provided with rich technical reserve,can play the minimally invasive advantage of laparoscopic surgery as well as ensure the safety of operation.LMH can enhance the recovery after surgery significantly and the value of further development,perfection and promotion.