Abstract:Objective:To evaluate the role of hepatectomy in the treatment of hepatolithiasis accompanied with hepatobiliary stricture.
Methods :The clinical data of 82 cases of hepatolithiasis who had surgical treatment during the past 16 years were reviewed.
Results:Preoperatively, all were examined with Bultrasound (accuracy: 75.6%), 46 cases with CT(accuracy: 87.0%), 22 cases with PTC(accuracy: 90.9%), 31 cases with ERCP(accuracy: 93.5%), and 18 cases with MRCP(accuracy: 94.4 %). All the cases were treated by resection of the hepatic lobe or segment with stones, cholangiotomy and removal of stones, hepatobiliary strictureplasty, and hepatocholangiojejunostomy at the hepatic hilum. Complications occurred in 17.1% of patients, the rate of residual stones was 15.9%. Seventythree cases were followed up for averag 10.6 years (1~16 years). In the followup period, the rate of recurrent stones was 6.8%. The excellent and good result rate was 90.4%.
Conclusions: (l) MRCP is the best technique for the diagnosis of hepatolithiasis accompanied with hepatobiliary stricture. (2) Hepatectomy is an effective means for treating patients with hepatolithiasis accompanied with hepatobiliary stricture. (3)The key to improve therapeatic results is to pay special attention in the treatment of bile duct stricture.