To investigate the application value of precise hepatectomy in clinical practice.

Clinical data of 317 patients who underwent hepatectomy in the People's Hospital of Lincang from January 2014 to December 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 202 patients were male and 115 female, aged 28-78 years with a median age of 47 years. Primary diseases: 207 patients were diagnosed with primary liver cancer, 6 cases of hilar cholangiocarcinoma, 8 cases of gallbladder carcinoma, 13 cases of hepatic hemangioma, 73 cases of intrahepatic bile duct stones and 10 cases of hepatic parasitic diseases. All patients were divided into the precise hepatectomy group (precise group, n=171), and non-anatomical hepatectomy groups (control group, n=146) according to different surgical methods. Intraoperative blood loss and postoperative length of hospital stay were compared between two groups by t test. The rate comparison was performed by Chi-square test or Fisher's exact test.

In precise group, the intraoperative blood loss and postoperative length of hospital stay were (528±69) ml and (18.3±2.4) d respectively, significantly less than (827±66) ml and (24.5±3.6) d in control group (t=-3.51, -2.87; P<0.05). In precise group, no postoperative bleeding, 1 case of bile leakage and 2 cases of perihepatic encapsulated effusion was observed, whereas it was correspondingly 1, 4, 7 cases in control group (χ²=-, 5.16, 4.68; P<0.05). In precise group, the 1-, 2-year tumor-free survival rates and stone recurrence rate were 73%(82/112), 51%(57/112) and 5%(2/39), significantly better than 56%(55/99), 40%(40/99) and 21%(7/34) in the control group (χ²=4.44, 3.82, 4.31; P<0.05), respectively.

Precise hepatectomy is a safe and efficacious surgery, which possesses advantages of slight intraoperative bleeding, low incidence of postoperative complications, short length of hospital stay, high postoperative tumor-free survival rate and low stone recurrence rate.