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[Hepatectomy for hepatolithiasis treatment of 354 cases]
1Department of Hepatobiliary Surgery, First Affiliated Hospital of Sun Yat-Sen, University of Medical Scienses, Guangzhou 510080.
Objective:
To evaluate the effect of hepatectomy for hepatolithiasis.
Method:
354 patients with hepatolithiasis underwent hepatectomy in the past 10 years. The results were analysed retrospectively, including clinical findings, distribution of stones, patterns of operation, postoperative complications, and residual stones. The clinical data of the patients before 1990 were compared with those thereafter.
Result:
Left hepatolithiasis was the most common form (323 patients). Left lateral lobectomy and left hepatectomy were most commonly employed (91.2%). 166 of the patients underwent concurrent cholangiojejunostomy. 13.8% patients had residual stones, and postoperative complications occurred in 60 patients, including 4 deaths. Few patients were reoperated on and the incidence of residual stones was lower after 1990. 88% the patients showed excellent or good result.
Conclusion:
Hepatectomy is a procedure for the management of hepatolithiasis, but still requires combined plasty of stenotic intrahepatic bile ducts and cholangiojejunostomy to reduce the incidence of residual stones and recurrence.