Comparison of laparoscopic versus open left lateral hepatectomy for hepatolithiasis in China

Abstract

Background: Primary hepatolithiasis is prevalent in Eastern Asia. Partial hepatectomy is the most effective and definitive treatment for hepatolithiasis. Laparoscopic surgery has been used in the treatment of hepatolithiasis but remains controversial due to the technical challenge. The objective of this study was to evaluate outcomes of laparoscopic left lateral hepatectomy (LLLH) for treatment of primary hepatolithiasis. Method: From June 2014 to June 2017, 105 consecutive patients with left intrahepatic duct stones who underwent LLLH (n = 35) or open left lateral hepatectomy (OLLH) (n = 70) were evaluated. We retrospectively reviewed the clinical outcomes and the stone clearance rates of the 2 groups in this study. Result: The volume of intraoperative blood loss was less in the LLLH than OLLH group (153 ml versus 204 ml; P = 0.140), but there was no significant difference. The postoperative hospitalization time was significantly shorter in the LLLH group than in the OLLH group (6.8 d versus 11.8 d; P< 0.001). The postoperative complication rate was significantly lower in the LLLH group (32.9% versus 8.6%; P = 0.007). There were no differences between the LLLH and OLLH groups in operation time, hepatic portal occlusion, blood transfusion, residual stone rate, and recurrent stone rate. Conclusion: In experienced hands, total LLLH provides clinical benefits and is a safe and effective procedure for selected patients with hepatolithiasis.Tabled 1EP03D-015 Operative and postoperative outcomes in two groupsOperative and postoperative characteristicsOLLH (n=70)LLLH (n=35)P valueOperation time （min）206 ± 70225 ± 770.180Blood loss（ml）204 ± 208153 ± 1260.140ICU stay (n,%）7 (10.0）2 (5.7）0.462Secondary surgery unplanned, n (%)5 (7.1）2 (5.7）0.783Postoperative hospital stay（d）11.8 ± 6.56.8 ± 2.7<0.001Overall complication,n (%)23 (32.9）3 (8.6）0.007Residual stone, n(%)7 (10.0）6 (17.1）0.297Final clearance, n (%)70 (100)35 (100)1Recurrence after surgery, n(%)1 (1.4）00.480 Open table in a new tab