Abstract: Objective To compare and analyze the clinical efficacy of laparoscopic and open hepatectomy in the treatment of primary hepatocellular carcinoma(HCC), so as to provide certain theoretical reference for clinical practice and improve the treatment level of HCC. Methods A total of 86 patients with HCC admitted to our hospital from January 2014 to January 2017 were selected and divided into control group and observation group by numerical random table method, with 43 cases each group. The control group underwent open hepatectomy, while the observation group underwent laparoscopic hepatectomy. The levels of intercellular adhesion molecules-1(ICAM-1), matrix metalloproteinases-13(MMP-13), procalcitonin(PCT), interleukin-6(IL-6), and the incidence of postoperative complications in the two groups were compared. Results The operative time, intraoperative blood loss, incision length, postoperative visual analogue pain(VAS) score, and length of postoperative hospital stay in the observation group were all lower than those in the control group(all P<0.05). Before treatment, the levels of ICAM-1, MMP-13, PCT and IL-6 in the two groups were not significantly different(all P>0.05). After treatment, the levels of ICAM-1, MMP-13, PCT and IL-6 in the observation group were(7.48±2.69) ng/mL,(121.03±23.61) ng/mL,(6.83±1.97) μg/mL and(13.58±4.29) pg/mL, respectively, which were all lower than those in the control group(13.07±3.86) ng/mL,(168.52±30.27) ng/mL,(8.32±2.67) μg/mL and(16.40±5.38) pg/mL(all P<0.05). The complication rate in the observation group was 6.99%, lower than 23.27% in the control group(P<0.05). Conclusion Both laparoscopic and open hepatectomy are common surgical treatment methods for primary HCC. Compared with open surgery, laparoscope-guided surgery is more effective, has the advantages of less trauma, faster postoperative recovery, less impact on inflammatory response, high safety.