Hepaticojejunostomy for hepatolithiasis: a critical appraisal
Shao-Qiang Li1, Li-Jian Liang, Bao-Gang Peng
1Department of Hepatobiliary Surgery, the First Affiliated Hospital of Sun Yet-san University, Guangzhou 510080, Guangdong Province, China.
World Journal of Gastroenterology
|July 11, 2006
Summary
Hepaticojejunostomy (HJ) for hepatolithiasis shows unsatisfactory outcomes due to high residual stone rates and postoperative cholangitis. This study suggests strict selection of indications for HJ in hepatolithiasis treatment.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Surgical Outcomes
Background:
- Hepatolithiasis, or bile duct stones, poses significant management challenges.
- Hepaticojejunostomy (HJ) is a surgical option, but its long-term efficacy requires evaluation.
Purpose of the Study:
- To assess the long-term outcomes of hepaticojejunostomy (HJ) in treating hepatolithiasis.
- To determine optimal surgical indications for HJ in hepatolithiasis management.
Main Methods:
- Retrospective review of 314 elective hepatolithiasis cases over 10 years.
- Comparison of HJ group versus T tube drainage group, with subgroups based on hepatectomy.
- Evaluation of stone residual rate, surgical efficacy, and long-term outcomes.
Main Results:
- No surgical mortality; 1.6% hospital mortality.
- HJ group had a higher rate of postoperative cholangitis (22.0%) compared to T tube drainage (8.2%).
- HJ hindered postoperative choledochoscopic lithotripsy, leading to higher residual stone rates (16.7%) versus T tube drainage (0.5%).
Conclusions:
- Hepaticojejunostomy (HJ) is not satisfactory for hepatolithiasis due to high residual stone and cholangitis rates.
- HJ is ineffective for draining residual stones and may impede optimal postoperative management.
- Strict selection of indications for HJ in hepatolithiasis is crucial.
