目的 探讨腹腔镜肝切除术与开腹肝切除术治疗原发性肝癌的疗效及远期预后.方法 将100例需行手术切除的原发性肝癌患者按照治疗方式分为腹腔镜组与开腹组.比较两组患者手术时间、术中出血量、住院时间、手术切口长度、并发症发生率、手术前后肝功能及3 a复发率、生存率. 结果 腹腔镜组手术时间显著长于开腹组(P<0.01),术中出血量、住院时间均显著少于开腹组(P<0.01),手术切口长度显著短于开腹组(P<0.01),并发症发生率显著低于开腹组(P<0.05).手术后两组谷草转氨酶与谷丙转氨酶水平均较手术前显著升高(P<0.01),腹腔镜组显著低于开腹组(P<0.01).两组患者术后3 a内复发率比较差异无统计学意义(P>0.05).结论 腹腔镜肝切除术治疗原发性肝癌安全有效,同时具有创伤小、恢复快、住院时间短、并发症少等特点,疗效与远期预后与开腹手术相当.、Objective To explore the short-term efficacy and long-term prognosis of laparoscopic hepatectomy versus open hepatectomy for primary liver cancer (PLC).Methods A total of 100 PLC patients needing excision were assigned to laparoscopic and open hepatectomy group.Such parameters were compared between to groups as operation time, intraoperative amount of bleeding, length of stay, incision length, complication incidence, pre-and post-liver function, relapse and survival rate within 3 years.Results Operation time was significantly longer (P<0.01), intraoperative amount of bleeding, length of stay and incision length fewer (P<0.01), and relapse rate lower (P<0.05) in laparoscopic than in open hepatectomy group.Post-operative AST and ALT levels of both groups heightened more significantly (P<0.01), their elevated degrees were significantly lower in laparoscopic than in open hepatectomy group (P<0.01).There was no significant group difference in relapse rate within 3 years after operation (P>0.05).Conclusion Laparoscopic hepatectomy is safe and effective in primary liver cancer, has such characteristics as small wound, quicker recovery, shorter length of stay, fewer complications, and its efficacy and long-term prognosis are equivalent to open hepatectomy.