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Caudate lobe-sparing subtotal hepatectomy for primary hepatolithiasis
1Hospital and Institute of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Chinese PLA Postgraduate Medical School, Beijing, China. dongjh301@163.com
The British Journal of Surgery
|September 11, 2012
Summary
Caudate lobe-sparing subtotal hepatectomy effectively treated patients with severe hepatolithiasis and cholangitis. This procedure offered a safe and successful alternative for managing complex liver conditions, leading to symptom relief in most cases.
Area of Science:
- Hepatobiliary surgery
- Gastroenterology
- Surgical oncology
Background:
- Bilateral primary hepatolithiasis can cause frequent, life-threatening cholangitis.
- Atrophy of the main liver with caudate lobe hypertrophy presents unique surgical challenges.
Purpose of the Study:
- To assess the safety and efficacy of caudate lobe-sparing subtotal hepatectomy.
- To evaluate outcomes in patients with complex hepatolithiasis and cholangitis.
Main Methods:
- Retrospective analysis of prospectively collected data (March 2003-December 2009).
- Subtotal hepatectomy involving resection of 7 liver segments, preserving the caudate lobe.
- Concomitant bile duct exploration and choledochoscopy were performed.
Main Results:
- Immediate stone clearance achieved in all 12 patients.
- No hospital mortality; 3 patients experienced 6 complications.
- At a mean 51-month follow-up, 11 of 12 patients remained symptom-free from cholangitis.
Conclusions:
- Caudate lobe-sparing subtotal hepatectomy is a safe and effective treatment for selected patients.
- This approach offers a viable solution for complex bilateral primary hepatolithiasis.
