Application of anatomic hepatectomy for re-operation of intrahepatolithiasis

Abstract

Objective To evaluate the applicative value of anatomic hepatectomy in re-operation of intrahepatolithiasis. Methods The clinical data of 45 patients undergoing anatomic hepatectomy in re-operation for residual or recurrent stones of intrahepatolithiasis were analyzed retrospectively. Results Of the 45 patients, 24 underwent anatomic left lateral lobectomy, 10 left hemihepatectomies, 5 anatomic segment Ⅳ resections (left lateral lobes were resected), 2 right hemihepatectomies, 1 seg-ment Ⅴ and Ⅶ resection, 1 segment Ⅵ and Ⅶ resection, 1 left hemihepatectomy combined with seg-ment Ⅴ resection, 1 left lateral lobectomy with segment Ⅵ resection. Eleven patients received hepato-jejunostomies with end-side Roux-Y fashion, 34 underwent T tube drainages of common bile duct. There was no operation death, postoperative complication rate was 22.22% (10/45) and the rate of residual stone was 6.7% (3/45). Forty of 45 patients were followed up for 16-63 months (mean= 43.4±21.5 months). During follow-up, there was no stone recurrence and reoperation after anatomic hepatectomies, and 2 patients who underwent hepatoenterostomies experienced acute cholangitis, which was controlled by antibiotic therapy. Conclusion The application of anatomic hepatectomy in re-operation of intrahepatolithiasis could effectively reduce the rate of residual stone after surgery, and it is safe and feasible. Key words: Hepatectomy; Intrahepatolithiasis; Prognosis