Surgical strategy of liver segmentectomy for hepatolithiasis
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R657.4

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    Abstract:

    Objective: To evaluate the efficacy of multiple hepatic segmentectomies for complex hepatolithiasis. Methods: The clinical data of 93 patients with hepatolithiasis who underwent multiple liver segmentectomies were retrospectively analyzed. The procedures included 5 cases of right lobectomy, 7 cases of right posterior lobectomy, 2 cases of right posterior lobe plus left lateral lobe resection, 1 case of segment VIII plus caudate lobectomy, 3 cases of segment VIII and left lateral lobe resection, 2 case of subtotal segment VII and VIII plus left lateral lobe resection, 5 cases of right anterior lobectomy, 2 cases of segment IV and V resection, 5 cases of segment IV, V and VIII resection, 19 cases of left lobectomy, 4 cases of left and caudate lobectomy, 6 cases of segment IV resection, and 32 cases of left lateral lobectomy. Additional choledochojejunostomy was performed in 22 cases. All the patients underwent cholecystectomy, cholangioscopic exploration and/or stone extraction, and common bile duct T-tube drainage. Results: There was no operative mortality. Postoperative complications occurred in 17 cases (18.2%),including 2 cases of bile leakage (2.2%), 1 case of subphrenic infection (1.1%), 6 cases of wound infection (6.4%), 3 cases of pulmonary infection (3.2%), 6 cases of pleural effusion (6.4%), and 2 cases of stress ulcer (2.2%). All of these complications resolved before the patients were discharged. In 9 cases, residual stones were found after operation and they were completely removed by cholangioscopy in 5 of them. Follow-up was obtained in 89 cases (95.7% of the whole group), of whom 3 cases with concomitant cholangiocarcinoma died of tumor recurrence and 3 cases developed bile duct stone recurrence. Conclusion: Multi-segmentectomies as the main operation modality is effective in the treatment of complex hepatolithiasis.

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LUO Kunlun, FANG Zheng, YU Feng, LIU Hong, TIAN Zhiqiang, DONG Zhitao. Surgical strategy of liver segmentectomy for hepatolithiasis[J]. Chin J Gen Surg,2012,21(2):127-131.
DOI:10.7659/j. issn.1005-6947.2012.02.001

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History
  • Received:October 11,2011
  • Revised:January 06,2012
  • Adopted:
  • Online: February 15,2012
  • Published: