In recent years, laparoscopic surgery has been widely carried out in various surgical fields, which is popular among patients because of the advantages of less trauma, faster postoperative recovery, less blow to the body’s immune system, and shorter hospital stay. The liver is rich in blood flow, has many important ducts and is complex, and the consequences of injury are serious, so laparoscopic hepatectomy has been relatively slow to develop compared to laparoscopic cholecystectomy and hepatic cyst surgery. At present, with the increasing maturity of clinical application of laparoscopic surgical techniques and the improvement and innovation of laparoscopic instruments, the application of laparoscopic hepatectomy has gradually increased, the safety of surgery has been greatly improved, and the original forbidden area of hepatectomy has been continuously broken through. 1. Indications for laparoscopic hepatectomy According to the reported literature on laparoscopic hepatectomy, the better indications are: liver function above Child-Pugh grade B, no serious lesions in other organs, the remaining liver can meet the physiological needs of the patient, and no previous history of upper abdominal surgery. Small confined tumors located on the superficial surface of segment II~VII of the liver; intrahepatic bile duct stones in the left outer lobe of the liver; benign and malignant tumors of the liver; liver cysts, etc. The size of benign tumor should be less than 8cm, and the diameter of malignant tumor generally does not exceed 5cm. tumor in segment VIII of the liver is close to the top of the diaphragm, which is difficult to reveal laparoscopically, therefore, laparoscopic resection is extremely difficult, and it is also easy to cause hepatic vein injury during the operation. 2.Key points of laparoscopic hepatectomy (1) laparoscopic irregular hepatectomy It is suitable for limited masses at the edge of the liver or on the surface of the liver. This procedure does not require dissection of the hepatic hilum, and the resection line is marked with an electric knife at a distance of 1-2 cm around the mass, and the liver tissue is separated by ultrasonic knife, and small bleeding points can be stopped by electrocoagulation, and larger vessels and bile ducts can be closed by biological clips or ligated under the microscope. If the liver tissue is thin, the liver tissue can be separated directly with a cutting closure (Endo-GIA) and the mass can be wedge-shaped. (2) Laparoscopic regular hepatectomy is indicated when resection of masses above the liver segment is required. The common ones are laparoscopic left lobectomy, left hemicolectomy and right hemicolectomy. The left lobectomy does not require blocking the hepatic portal, freeing the left perihepatic ligament, separating the hepatic artery, portal vein and bile duct entering the left outer lobe, and cutting them off with Endo-GIA clamping, then cutting the liver with ultrasonic knife along the left side of the sickle ligament for 1 cm, and using electrocoagulation to stop bleeding and striated tissue, biopin or titanium clamps to close them. When the left hepatic vein is encountered, the liver is cut with Endo-GIA semi-closed in the liver parenchyma, and the liver tissue is continued to be separated by ultrasonic knife until the left outer lobe is completely resected. Regular resection of the left liver includes the left outer lobe and the left inner lobe, and the caudate lobe is usually resected. The left liver was firstly freed, the left perihepatic ligament was severed, the first hepatic hilar was dissected, the blood flow into the liver was controlled, and the hepatic artery, portal vein and bile duct entering the left hepatic hemisphere were dissected out separately and resected with Endo-GIA clamping. At this time, the left and right hepatic hemispheres are clearly demarcated, and the hepatic parenchyma is separated by electric knife or ultrasonic knife along the left side of 1 cm of this demarcation line, and the ducts encountered are larger than 2 mm and need to be closed with biological clamps or titanium clamps and then cut off. The second hepatic hilar can also be dissected, and the left hepatic vein can be cut off with Endo-GIA closure outside the liver, but it is very dangerous to separate the hepatic vein outside the liver during laparoscopy, and improper treatment can cause hemorrhage and easy to develop angry embolism (low pressure of hepatic vein, pneumoperitoneum should be established during laparoscopy), which can cause death of the patient, so the hepatic vein should be separated outside the liver and clamped and cut off with caution. This is done until complete resection of the left half of the liver. Complete hemostasis of the liver section is achieved with electrocoagulation hemostasis, spraying of medical bioprotein gel, hemostatic covering, etc. The excised liver is removed with a specimen bag and an abdominal drainage tube is placed below the liver section. The main points of right hepatectomy are the same as left hepatectomy, including: freeing the right hepatic half, severing the right hepatic perihepatic ligament, severing the hepatic artery, portal vein and right hepatic duct entering the right hepatic half, severing the liver 1cm along the left side of the left and right hepatic dividing line, and closing and severing the right hepatic vein with Endo-GIA. 3.Common complications and prevention of laparoscopic hepatectomy Patients recover quickly after laparoscopic hepatectomy, they can get out of bed in 1~2 days after surgery, and can eat in 2~3 days. Common complications include bleeding, bile leak, bile duct stricture, hepatic insufficiency, pulmonary infection, small bowel perforation, phlebitis, and gas embolism. One author retrospectively analyzed the results of 186 laparoscopic hepatectomies with a complication rate of 16.1% and 2 cases of suspected gas embolism (1.1%). With the increasing maturity of laparoscopic hepatectomy techniques, the complications of laparoscopic hepatectomy have recently shown a decreasing trend. The methods of prevention mainly include: the surgical operation should be delicate, and intraoperative bleeding should not be stopped by blind electrocoagulation or clamping, and the cause and site should be investigated before treatment. If the bleeding cannot be controlled, the operation should be immediately transferred to open surgery. After the operation, the abdominal cavity should be carefully examined, the wound should be flushed, and the operation should be finished after it is clear that there is no bile leak, bleeding, or side injury to the surrounding organs. Closely observe the patient’s vital signs and abdominal drainage after surgery to detect complications early and deal with them immediately.