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Published on: September 27, 2024
Laparoscopic left hemihepatectomy for left intrahepatic duct stones
Chi-Young Jeong1, Ka-Jeong Kim, Soon-Chan Hong
1Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea.
Insights
Laparoscopic left hemihepatectomy is a feasible treatment for intrahepatic duct stones. This minimally invasive approach achieved a 100% stone clearance rate with no recurrence in a 22-month follow-up.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Procedures
- Gastroenterology
Background:
- Intrahepatic duct (IHD) stones pose a management challenge.
- Surgical intervention is often required for complex cases.
Purpose of the Study:
- To evaluate the feasibility of laparoscopic left hemihepatectomy for intrahepatic duct stones.
- To assess the safety and efficacy of this minimally invasive approach.
Main Methods:
- Retrospective review of 26 patients undergoing laparoscopic left hemihepatectomy for IHD stones.
- Data collected on operative time, postoperative stay, complications, and stone clearance.
Main Results:
- Mean operation time: 312.1 minutes; Mean hospital stay: 11.8 days.
- Initial stone clearance rate: 92.3%; Final clearance rate: 100% after endoscopic retrograde cholangiopancreatography.
- Complications included bile leakage and fluid collection, managed conservatively. No recurrent stones observed during follow-up.
Conclusions:
- Laparoscopic left hemihepatectomy is an effective treatment for select patients with IHD stones.
- Minimally invasive surgery offers a viable alternative with high success rates.
Purpose:
The feasibility of laparoscopic left hemihepatectomy for the management of intrahepatic duct (IHD) stones was evaluated.
Methods:
The clinical data of 26 consecutive patients who underwent total laparoscopic left hemihepatectomy for IHD stones at Gyeongsang National University Hospital between January 2009 and June 2011 were reviewed retrospectively.
Results:
The mean operation time was 312.1 ± 63.4 minutes and the mean postoperative hospital stay was 11.8 ± 5.0 days. There were 2 cases of postoperative bile leakage and 3 cases of intra-abdominal fluid collection, which were successfully managed conservatively. Remnant stones were detected in 2 patients. The initial success rate of stone clearance was 92.3% (24 of 26). The remnant stones were located in the common bile duct in both cases and were removed by endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy. Therefore, the final success rate of stone clearance was 100% (26 of 26). During a mean follow-up of 22 months (range, 7 to 36 months), there was no patient with recurrent stone.
Conclusion:
Laparoscopic surgery could be an effective treatment modality for the management of IHD stones in select patients.
