Abstract: Objective To investigate the clinical effects of laparoscopic hepatectomy and open hepatectomy. Methods A total of 120 patients with primary liver cancer in our hospital from February 2015 to July 2017 were randomly divided into A group and B group by random number method. A group was given laparoscopic hepatectomy, and B group was given open hepatectomy. The perioperative indicators, peripheral blood T lymphocyte subsets, and short-term and long-term effects of two groups were compared. Results The intraoperative blood loss, eating time, getting out bed time, hospital stay, and analgesic dose of A group[(145.48±12.59) mL,(1.65±0.52) d,(4.60±0.78) d,(10.07±1.17) d,(139.24±62.47) mg] were significantly lower than B group[(202.56±13.68) mL,(2.73±0.75) d,(6.84±0.90) d,(13.22±1.36) d,(282.79±80.01) mg], t=23.782, 9.166, 14.596, 13.601 and 10.954, all P<0.05. After one week, the CD3⁺ and CD4⁺ of A group[(55.33±5.70),(46.18±7.33)] were significantly higher than B group[(51.97±3.29),(41.60±6.53)], t=3.955, 3.614, all P<0.05, the CD8⁺ of A group(30.07±3.26) was significantly lower than B group(33.60±3.31), t=5.886, P<0.05. The complications incidence of A group(3.33%) was significantly lower than B group(13.33%), χ²=3.927, P<0.05. Conclusion Compared with open hepatectomy, laparoscopic hepatectomy could effectively treat primary liver cancer.