الفهرس 
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Abstract
Laparoscopic approach in management of HCC has been progressively developed along the past two decades. Liver surgery was one of the last frontiers reached by minimally invasive surgery. Surgical technique and equipment evolved to overcome technical limitations, making laparoscopic liver resections (LLR) safe and feasible. Surgeons developed skills in a stepwise approach, beginning with low complexity operations for benign diseases and reaching high-complexity surgeries for malignant cases and living donor organ harvesting (Coelho et al., 2016).
The laparoscopic approach has been increasingly gaining popularity as one of the minimally-invasive treatments of HCC (Kawaguchi et al., 2017).
In this study, a comparison between laparoscopic approach and open approach was done to compare short-term results. This study was conducted on 100 patients with hepatocellular carcinoma. 50 patients (50%) were treated by laparoscopic approach (group A) while the other 50 patients (50%) were treated by open approach (group B).
Regarding the demographic data, the presence of past history of medical condition and the preoperative laboratory results, no statistical significance was found.
All cases were classified to be CHILD grade A with median MELD score in laparoscopic group was 8.96±1.72 ranging from 6 to 14 while in open group the mean MELD sore was 8.2 ±1.42 ranging from 6 to 11.The difference was statistically not significant. (P<0.254)
The mean operative time in open group was 158.15 ±35.9 minutes, while the laparoscopic group mean time was 130.4 ±38.1 minutes with statistically significant difference between the 2 groups, (P< 0.001) with decreased operative time in the laparoscopic group.
The mean blood loss in open group was 390 ±193.7ml while the laparoscopic group mean blood loss was 386 ±371.1ml with no statistically significant difference relations between the 2 groups, (P= 0.671), with conversion rate of (10%) happened in 5 cases.
The mean hospital stay in open group was 5.9± .88 days ranging from 3-7 days, while the laparoscopic group was 3.74±.85 days ranging from 2-5 days with highly statistically positive correlation difference between 2 groups (P< 0.001). Also the drain was removed in the laparoscopic group earlier showing highly statistical difference between two groups (P< 0.001).
the most frequent complication was postoperative ascites and which was seen in 35 (70%) cases in the open group and in 23 (46%) cases in laparoscopic group with highly significant difference between both groups with much more lower incidence in laparoscopic group (P<0.004).
There was a case of histologically proved port site metastasis in laparoscopic group at the right subcostal port where the specimen is extracted with percentage of (2 %) (P=1.00).
Hepatocellular carcinoma was found in all patients in both groups. There were 42 patients moderate differentiation (84%) in laparoscopic group, with mean resection margin of 8.1±2.2 mm while moderately-differentiated in 41 (82%) patients (82%) in open group with mean resection margin 7.62±2.28 mm with no statistical significance (P=0.132).
Recurrence occurred in 2 patients (4 %) in group A and 1 patient (2 %) in group B while mortality occurred in only one patient (3.05%) in the open group in the laparoscopic group, the 1-year survival was 98 %, while in the open group was (96 %). (P=1.00).
In the laparoscopic group, the 1-year survival was 98 %, while in the open group was (96%). (P=1.00).