Precise hepatectomy for hepatolithiasis

Abstract

Objective To evaluate the safety and efficacy of precise hepatectomy in treatment of hepatolithiasis. Methods Clinical data of 93 patients with hepatolithiasis who underwent hepatectomy in Anhui Provincial Hospital between January 2013 and January 2017 were analyzed retrospectively. The patients were divided into precise hepatectomy group (precise group, n=59) and conventional resection group (conventional group, n=34) according to different surgical procedures. There were 28 males and 31 females in precise group, with an average age of (56±5) years old. There were 18 males and 16 females in conventional group, with an average age of (56±4) years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The operation time, intraoperative blood loss, postoperative length of stay, postoperative ALT, AST level between two groups were compared by t test or Kruskal-Wallis rank sum test. The incidence of postoperative complication was compared by Chi-square test. Results The operation time was (210±61) min in precise group, significantly longer than (157±60) min in conventional group (t=1.586, P<0.05). The intraoperative blood loss was (386±99) ml in precise group, significantly less than (518±153) ml in conventional group (t=-1.421, P<0.05). The median postoperative length of stay was 8(6-10) d in precise group, significantly shorter than 10(8-15) d in conventional group (Z=-2.018, P<0.05). The ALT and AST level at postoperative 1 d was respectively (214±87) and (368±106) U/L in precise group, significantly lower than (594±133) and (625±165) U/L in conventional group, (t=-3.395, -2.047; P<0.05). The incidence of postoperative complication was 8.5% (5/59) in precise group, significantly lower than 23.5%(8/34) in conventional group (χ2=4.066, P<0.05). Conclusions Compared with conventional hepatectomy, precise hepatectomy possesses advantages of smaller surgical trauma, less intraoperative blood loss and lower incidence of postoperative complication. It has better clinical application value. Key words: Hepatectomy; Bile ducts, intrahepatic; Cholelithiasis