Objective To observe the efficacy and safety of total hepatic inflow occlusion (Pringle maneuver) and selective hepatic inflow occlusion via Glisson's pedicle in laparoscopic hepatectomy. Methods A prospective study was conducted on patients who underwent laparoscopic hepatectomy at Shunde Hospital of Southern Medical University from January 2022 to December 2023. After propensity score matching, 60 patients were enrolled and randomly divided into two groups: 30 patients in the Glisson group and 30 patients in the Pringle group. The Pringle group underwent total hepatic inflow occlusion, while the Glisson group received selective hepatic inflow occlusion via Glisson's pedicle. The surgical-related indicators, levels of serum total bilirubin (TBiL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin (ALB), as well as the incidence of postoperative complications were compared between the two groups. Results There was no statistically significant difference in tumor resection margin, operation time and intraoperative blood loss between the two groups (all P>0.05). Compared with the preoperative levels, the levels of TBiL, AST, and ALT in both groups increased, while the ALB level decreased after the surgery. Moreover, postoperatively, the Glisson group had lower levels of TBiL, AST, and ALT and a higher ALB level than the Pringle group, and all these differences were statistically significant (all P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (20.00% vs. 22.67%) (P>0.05).Conclusion Compared with total hepatic inflow occlusion, the use of selective hepatic inflow occlusion via the Glisson's pedicle in laparoscopic hepatectomy does not increase the operation time, intraoperative blood loss, or the incidence of postoperative complications, and it has certain advantages in liver function protection.

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