Comparison Of Laparoscopic Versus Open Hepatectomy For Tumor Distributed In The Right Posterior Lobe Of Liver

Objective:As the development of laparoscopic technology, more and more operation can be completed by the help of laparoscope. After successfully used in hepatectomy by Reich and his colleagues in 1991, laparoscope is widely used in the operation for tumor in liver. Laparoscopic hepatic left lateral sectionectomy has been a routine therapy for tumor in the left lateral lobe of liver. But for tumors distributed in the right hemiliver especially in the right posterior lobe of liver,the operation via laparoscope is still regarded as a procedure that is difficult and dangerous, because it is very hard for exposure and hemostasis. We compared patients who excepted either laparoscopic hepatectomy or open hepatectomy for the treatment of tumor distributed in the right posterior lobe of liver, aiming to evaluate the feasibility and safety of laparoscopic hepatectomy and to introduce some operative skills.Materials and Methods:According to the criteria of inclusion and exclusion, we collected 72 cases who accepted operation for tumor distributed in the right posterior lobe of liver in Qilu Hospital of Shandong University during the period from July, 2010 to December,2015.34 of the patients accepted laparoscopic hepatectomy and 38 accepted open hepatectomy. We compared the two groups in the aspects of general condition of patients, data of tumor, length of incision, operation time, hemorrhage during operation, intraoperative blood infusion, liver function of perioperation period, time for carrying abdominal cavity drainage tube, complication rate and postoperation hospitalization duration to find out the advantages and disadvantages of laparoscopic hepatectomy compared with the open hepatectomy for the treatment of tumor distributed in the right posterior lobe of liver.Results:Through the comparison of the two groups, it can be proved that the general condition of patients, data of tumor, hemorrhage during operation, intraoperative blood infusion, operation time and complication rate have no statistical difference(p>0.05). Laparoscopic hepatectomy is superior to open hepatectomy in the aspects of length of incision, postoperation liver function, time for carrying abdominal cavity drainage tube and postoperation hospitalization duration, and the differences have statistical significance(p<0.05).Conclusion:Compared with open hepatectomy, laparoscopic hepatectomy has advantages such as smaller incision, quicker refection and shorter postoperation hospitalization duration. It is feasible and safe, so should be generalized in clinic. This requires surgeons to have enough capacity for manipulating laparoscope, to be more conversant in hepatic anatomy and can quickly dealing with hemorrhage. In the future, with regard to the tumor distributed in the right posterior lobe of liver, after excluding the contraindication, laparoscopic hepatectomy should be the therapeutic regimen that is considered preferentially.