Laparoscopic hepatectomy and open hepatectomy in treatment of hepatocellular carcinoma

Objective To explore the perioperative situation of patients with hepatocellular carcinoma (HCC) treated with laparoscopic hepatectomy or open hepatectomy and their effects on liver function. Methods A retrospective analysis was conducted on 85 patients with HCC who visited the Department of Biliary and Pancreatic Surgery, Shanxi Bethune Hospital from January 2020 to December 2022. According to the surgical methods, the patients were divided into open group (open hepatectomy, n=53) and laparoscopic group (laparoscopic hepatectomy, n=32). Both groups of patients were followed up for one month after discharge. The general information, intraoperative conditions, postoperative complications, and liver function indicators were compared between two groups of patients. Results Compared with the open group, the laparoscopic group had shorter hospitalization time ［(14.19±3.02) d vs (16.36±3.30) d, t=3.03, P＜0.01］, as well as shorter time for the first postoperative anal evacuation ［(2.30±0.77) d vs (2.75±0.49) d, t=3.29, P＜0.01］ and less intraoperative bleeding ［(395.63±70.25) mL vs (440.38±62.42) mL, t=3.05, P＜0.01］. Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase levels were lower in the laparoscopic group than those in the open group at 3 days postoperatively, and the difference was statistically significant (P＜0.05). In the 1-month postoperative period, the difference in the overall rate of postoperative complications between the two groups was not statistically significant (15.63% vs 16.98%, χ2=0.92, P=0.34). Conclusion For patients with HCC, the application of laparoscopic hepatectomy is safe and feasible, which can reduce the impact on liver function, shorten hospitalization time, and promote early recovery.