Three-dimensional anatomic localization staining of hepatic segments in anatomic hepatectomy for primary hepatolithiasis

Abstract

Background: The clinical significance of anatomic hepatectomy (AH) for the treatment of primary hepatolithiasis (PHL) is not clear. And there are certain limitations to the current staining techniques in use with regard to the visualization of the affected areas. The aim of this study is to present a newly-established staining technique termed “three-dimensional (3D) anatomic localization staining of hepatic segments” (3D ALSHS). Methods: Sixty-nine PHL patients who underwent hepatectomy between January 2009 and December 2013 were studied retrospectively. Demographic, operative and follow-up data were collected prospectively and analyzed retrospectively. The patients were classified into the AH (n = 33) and non-AH (n = 36) groups. AH with 3D ALSHS was performed in the AH group. We evaluated the intraoperative data, and the short-term and long-term outcomes. Results: The final stone clearance rate and stone recurrence rate were significantly better in the AH group than in the non-AH group (97.0% vs. 77.8%, P = 0.029; 6.7% vs. 35.7%, P = 0.025). The AH group had significantly less intraoperative blood loss (219 mL vs. 466 mL, P = 0.001) and a significantly lower number of patients who received blood transfusion (6.1% vs. 38.9%, P = 0.003). Further, the AH group patients recovered more quickly after surgery (median hospital stay: 22 days vs. 26 days, P = 0.001). Conclusion: This staining technique for AH had several advantages over the non-AH technique for PHL patients and should be further evaluated clinically in PHL patients.