Abstract：Objective To compare the effect of different approaches in left extrahepatic lobectomy. Methods A total of 82 patients who needed to undergo left extrahepatic lobotomy in the First People′s Hospital of Jiujiang City from March 2017 to April 2020 were selected as the research subjects. According to random number table method, they were divided into group A and group B, with 41 cases in each group. Group A used the first hepatic portal approach, and group B used the transhepatic round ligament approach. The operation-related indexes, traumatic stress index before and 1 d after operation, liver function (alanine aminotransferase [ALT], aspartate aminotransferase [AST], hepatocyte growth factor [HGF]) before and 3 months after operation were compared between the two groups. Results There was no statistically significant difference in operation time between the two groups (P>0.05). The intraoperative blood loss in group B was lower than that in group A, and the difference was statistically significant (P<0.05). 1 day after surgery, the levels of adrenaline, interleukin-6 (IL-6), cortisol (Cor) and procalcitonin (PCT) in the groups were higher than those before surgery, and the levels of adrenaline, IL-6, Cor and PCT in group B were lower than those in group A, and the differences were statistically significant (P<0.05). 3 months after surgery, the levels of ALT, AST and TBil in the groups were lower than those before surgery, while the levels of HGF and ALB were higher than thise before surgery, and the level of HGF in group B was higher than that in group A, and the differences were statistically significant (P<0.05). 3 months after operation, there were no statistically significant differences in ALT, AST, TBil and ALB levels between the two groups (P>0.05). Conclusion Compared with the first hepatic portal approach, the transhepatic round ligament fissure approach can reduce the amount of intraoperative blood loss in patients undergoing left extrahepatic lobectomy and promote the recovery of liver function.
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