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Hepatic resection for bilateral hepatolithiasis: a 20-year experience
Chia-Cheng Lin1, Ping-Yi Lin, Chih-Jan Ko
1Division of General Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
ANZ Journal of Surgery
|September 28, 2012
Summary
Hepatic resection for bilateral hepatolithiasis yields poorer outcomes than unilateral cases, with lower stone clearance and higher recurrence rates. Younger patients with bilateral stones face increased recurrence risk, highlighting challenges in surgical management.
Area of Science:
- Hepatobiliary surgery
- Gastroenterology
- Surgical outcomes research
Background:
- Hepatic resection is a primary treatment for unilateral hepatolithiasis.
- The efficacy of hepatic resection for bilateral hepatolithiasis remains under-investigated.
Purpose of the Study:
- To compare the outcomes of hepatic resection for unilateral versus bilateral hepatolithiasis.
- To identify factors influencing treatment success in bilateral hepatolithiasis.
Main Methods:
- Retrospective review of 197 patients undergoing hepatic resection for hepatolithiasis (1987-2007).
- Patients were categorized into unilateral (UNI, n=156) and bilateral (BI, n=41) groups.
- Short- and long-term outcomes were analyzed.
Main Results:
- The BI group exhibited longer operating times, lower immediate and final stone clearance rates, and higher rates of stone recurrence and disease-related mortality compared to the UNI group.
- Bilateral peripheral stones were associated with lower immediate stone clearance.
- Younger patients (<35 years) showed a higher risk of stone recurrence.
Conclusions:
- Bilateral hepatolithiasis is associated with inferior outcomes following hepatic resection compared to unilateral disease.
- Discrepancies in parenchyma involvement and resection extent contribute to lower clearance rates in bilateral peripheral stones.
- Younger age is a risk factor for stone recurrence in patients with bilateral hepatolithiasis.