To compare the short-term outcomes between three-dimensional (3D) and two-dimensional laparoscopic hepatectomy for hepatocellular carcinoma.

The clinical data of 79 patients who underwent laparoscopic hepatectomy at Peking University Shougang Hospital from April 16, 2018 to December 31, 2020 were analyzed retrospectively. There were 54 males and 25 females, aged from 26 to 81, with an average of (57.6±10.7) years. Among them, 30 patients received 2D laparoscopic hepatectomy and 49 received 3D laparoscopic hepatectomy. Indexes of operation time, intraoperative blood loss, postoperative hospital stay, hospitalization expenses, and postoperative complications were observed.

There were no significant differences in gender, age, body mass index, preoperative liver function grade, tumor size, tumor number, or hepatectomy range between the two groups (P＞0.05). The operation time [(170.8±59.2) min] and intraoperative blood loss [(251.2±175.1) ml] of the 3D laparoscopic hepatectomy group were significantly less than those of the 2D laparoscopic hepatectomy group [(207.7±98.6) min, (387.3±284.7) ml; P＜0.05]. In terms of postoperative complications, the rate of total complications was similar between the 3D laparoscopic hepatectomy group and 2D laparoscopic hepatectomy group (24.5% vs 30.0%, P＞0.05). The incidence of postoperative bile leakage in the 3D laparoscopic hepatectomy group (2.0%) was significantly lower than that of the 2D laparoscopic hepatectomy group (16.7%; P＜0.05). The postoperative hospitalization days and hospitalization expenses of the two groups were similar (P＞0.05).

Compared with 2D laparoscopic hepatectomy, 3D laparoscopic hepatectomy is associated with less blood loss, shorter operation time, and lower incidence of postoperative bile leakage.