Objective To compare the clinical effects of fluid management guided by inferior vena cava collapse rate and central venous pressure (CVP) in laparoscopic liver lobectomy.

Methods A retrospective analysis was conducted on the data of 130 patients treated with laparoscopic liver lobectomy from April 2022 to April 2025. According to the fluid management methods, the patients were divided into the central group (64 cases) and inferior lumen group (66 cases). The surgery-related indicators, hemodynamic levels, liver and kidney functions, coagulation functions and incidence of postoperative complications were compared between two groups. Resuls After intervention, the creatinine (Cr), blood urea nitrogen (BUN), aspartate aminotransferase (AST) and total bilirubin (TBIL) of the two groups were all increased compared with those before the operation in the same group. The thrombin time (TT) and activated partial thrombin time (APTT) were also prolonged compared with those before the operation, and the fibrinogen (FIB) decreased (P ＜ 0.01). After 3 days of operation, the levels of APTT, Cr, BUN, AST and TBIL in the inferior lumen group were lower than those in the central group, and the FIB was higher than that in the central group (P ＜ 0.01). Moreover, the mean arterial pressure (MAP) at the time of liver lobectomy and at the end of the operation in two groups was lower than that before the operation in the same group, and the heart rate (HR) was higher (P ＜ 0.01). The MAP in the inferior lumen group was higher than that in the central group, the HR was lower than that of the central group (P ＜ 0.01). However, the intraoperative blood loss and total infusion volume in the inferior lumen group were less than those in the central group, and the central venous pressure level during liver resection was lower than that in the central group (P ＜ 0.05), but there was no statistical significance in the incidence of complications between two groups (P ＞ 0.05).

Conclusions Compared with CVP-guided fluid management, the use of inferior vena cava collapse rate guidance in laparoscopic liver lobectomy can better maintain hemodynamic stability, reduce intraoperative blood loss, and alleviate the impact on coagulation function and liver and kidney functions.