Clinical experience in treatment of complex intrahepatic bile duct stones by regular hepatectomy
10.3969/j.issn.1001-5256.2016.09.025
- VernacularTitle:规则肝切除术治疗复杂肝内胆管结石的临床体会
- Author:
Xiao WU
1
;
Hao XIA
;
Jian WU
Author Information
1. Department of General Surgery, The People′s Hospital of Shishou City, Shishou, Hubei 434100, China
- Publication Type:Research Article
- Keywords:
cholelithiasis;
bile ducts, intrahepatic;
hepatectomy;
treatment outcome
- From:
Journal of Clinical Hepatology
2016;32(9):1756-1759
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the clinical effect of regular hepatectomy in patients with complex intrahepatic bile duct stones. MethodsA retrospective analysis was performed for the clinical data of 98 patients with complex intrahepatic bile duct stones who were treated in our hospital from January to December, 2013. The distribution characteristics of intrahepatic bile duct stones, clinical manifestations, extent of operation, time of operation, complications, and surgical outcome were analyzed. ResultsAll the 98 patients completed regular hepatectomy. Of all patients, 37 underwent choledocholithotomy with T-tube drainage and segmental hepatectomy, 6 underwent resection of the left lateral lobe of the liver, 1 underwent left hemihepatectomy, 7 underwent resection of a single hepatic segment in the right lobe of the liver combined with segmental hepatectomy, 45 underwent combined segmental hepatectomy of the left and right lobes of the liver, and 2 underwent biliary-enteric basin anastomosis after hilar bile duct reconstruction. No patients died during the perioperative period. The mean time of operation was 65.0±5.0 min, and the mean intraoperative blood loss was 83.0±6.2 ml. No patients experienced residual stones after surgery. Of all patients, 5 (5.1%) experienced complications, among whom 3 experienced bile leakage and 2 experienced blood exudation on the surface of the wound in the liver; 3 patients were diagnosed with intrahepatic cholangiocarcinoma by postoperative pathological examination. All the patients for followed up for 5 years, and 11 (11.2%) experienced recurrence of stones after surgery. ConclusionRegular hepatectomy is safe and effective in the treatment of complex intrahepatic bile duct stones, with few complications and a low recurrence rate of stones. Therefore, it holds promise for wide clinical application.
