Objective: To investigate the value of using liver parenchyma transection-first approach in laparoscopic right hemihepatectomy. 
Methods: The clinical data of 20 patients undergoing laparoscopic right hemihepatectomy from October 2016 to October 2017 in the Second Affiliated Hospital of Army Medical University were retrospectively analyzed. Of the patients, 10 cases underwent laparoscopic right hemihepatectomy using liver parenchyma transection-first approach (observation group), namely, liver parenchyma transection was prioritized rather than dissection of the first hepatic hilum, and the other 10 cases underwent laparoscopic right hemihepatectomy with the conventional process, namely liver parenchyma transection after dissection of the first hepatic hilum (control group). The main clinical variables were compared between the two groups. 
Results: There were on significant differences in the general data between the two groups (all P>0.05). Operations were successfully completed in all patients of the two groups. In observation group compared with control group, the operative time was significantly shortened [(273.0±70.4) min vs. (203.0±61.3) min, P<0.05], and the intraoperative blood loss was significantly decreased [(470.0±427.0) mL vs. (270.0±149.4) mL, P<0.05], while the amount of intraoperative blood transfusion showed no significant difference (P>0.05). There were no significant differences in postoperative liver function parameters, length of postoperative hospital stay and incidence of complications as well as the incidence of tumor recurrence and metastasis (all P>0.05).
Conclusion: Liver parenchyma transection-first approach is a safe and effective procedure for laparoscopic right hemihepatectomy.