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With experience accumulation and technique innovation, laparoscopic left hemihepatectomy was performed in hepatocellular carcinoma patients. This study was designed to compare the perioperative outcomes of left hemihepatectomy through the laparoscopic and the open approaches.From May 2012 to December 2014, we performed left hemihepatectomy in 45 hepatocellular carcinoma patients. Laparoscopic left hemihepatectomy (LLH) was performed in 20 patients and open left hemihepatectomy (OLH) was performed in 25 patients. All clinical data were analyzed retrospectively.The mean duration of operation was 143±35.6 minutes in the LLH and 137±29.8 minutes in the OLH group; no statistically significant difference was found between the 2 groups. The median blood loss in the LLH group was less than that in the OLH group (180±20.5 vs. 350±45.3 mL, P<0.05). The mean postoperative hospital stay was significantly lower in LLH compared with OLH (7±1 vs. 12±2.0 d; P<0.05). The postoperative morbidity rate was also significantly different between the groups; there was a tendency toward more severe complications in the OLH group compared with the LLH group.LLH can decrease complications, shorten the hospitalization time, is minimally invasive, and is a safe and effective technique.