To evaluate the safety and clinical efficacy of laparoscopic right hemihepatectomy via anterior approach in the treatment of hepatocellular carcinoma (HCC).

Clinical data of 30 patients with HCC who underwent right hemihepatectomy in the First People's Hospital of Foshan from February 2014 to October 2019 were retrospectively analyzed. Among them, 28 patients were male and2 female, aged 24-74 years, with a median age of 51 years. According to the surgical methods, all patients were divided into the laparoscopic right hemihepatectomy via anterior approach group (laparoscopic group, n=11) and open right hemihepatectomy via anterior approach group (open group, n=19). The informed consents of all patients were obtained and the local ethical committee approval was received. The operation time and length of postoperative hospital stay between two groups were compared by t test. Intraoperative blood loss was statistically compared by rank-sum test. The incidence of postoperative complications was compared by Fisher's exact test.

All patients successfully completed the surgery without perioperative death. In the laparoscopic group, the median intraoperative blood loss was 300 (200-400) ml, significantly less than 500 (300-600) ml in the open group (Z=-2.539, P<0.05). The average operation time in the laparoscopic and open group was (361±57) min and (322±62) min respectively, where no significant difference was observed (t=1.739, P>0.05). In the laparoscopic group, the length of postoperative hospital stay was (8.8±1.3) d, significantly shorter than (13.0±6.4) d in the open group (t=-1.974, P<0.05). In the laparoscopic group, 6 cases developed postoperative pleural effusion and 1 case bile leakage, and accordingly 9 cases and 0 in the open group, and no significant difference was observed between two groups (P=0.705, 0.686).

Laparoscopic right hemihepatectomy via anterior approach isa safe and feasible treatment for HCC, which can significantly reduce the intraoperative blood loss and accelerate postoperative rehabilitation of HCC patients.