Surgical Outcome of Hepatic Resections for Hepatolithiasis.
- Author:
Seung Je GO
1
;
Min Koo LEE
;
Joo Seung PARK
;
Yoon Jung KANG
;
Byung Sun CHO
;
Chang Nam KIM
;
Young Jin CHOI
;
Hye Won PARK
Author Information
1. Department of Surgery, Eulji Medical University School of Medicine, Daejeon, Korea. mklee @eulji.ac.kr
- Publication Type:Original Article
- Keywords:
Hepatolithiasis;
Hepatic resection;
Complication
- MeSH:
Abscess;
Atrophy;
Cholangiocarcinoma;
Cholangitis;
Constriction, Pathologic;
Drainage;
Hemorrhage;
Hepatectomy;
Humans;
Liver Abscess;
Liver Cirrhosis;
Liver Failure;
Mastectomy, Segmental;
Pleural Effusion;
Pneumonia;
Postoperative Complications;
Recurrence;
Retrospective Studies;
Surgical Procedures, Operative;
Wound Infection
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2007;11(4):28-33
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Hepatolithiasis results in septic cholangitis, biliary stricture, hepatic atrophy, hepatic abscess, irreversible liver cirrhosis, and cholangiocarcinoma. Hepatic resection for hepatolithiasis is regarded as a more effective treatment for achieving complete removal of stones and preventing recurrence. The purpose of this study was to determine the surgical outcome of hepatic resections for hepatolithiasis. METHODS: From March 2001 to December 2006, 54 patients underwent hepatic resections for hepatolithiasis at the Department of Surgery, Eulji University Hospital. A retrospective review of the surgical outcome was carried out. RESULTS: The hepatolithiasis was located in the left intrahepatic duct (34 cases), right intrahepatic duct (7 cases) or both (13 cases). The operative procedures were as follows: a left hepatectomy in 34 patients, a left lateral sectionectomy in eight, a right posterior sectionectomy in three, a left trisectionectomy in three, a right hepatectomy in five, and a segmentectomy in 1. The postoperative complications were intraabdominal abscess in 10 patients, wound infection in 4, pleural effusion in 3, internal bleeding in 2, T-tube site leakage in 2, hepatic failure and pneumonia in 1. The factors that affect these complications were analyzed. Preoperative percutaneous transhepatic biliary drainage (PTBD) and operative hepaticojejunostomy increased the frequency of postoperative complications; these findings were statistically significant (p=0.035, p=0.006, respectively). Two patients were diagnosed with cholagiocarcinoma. Five patients had remaining stones and five patients had recurrent stones. CONCLUSION: Hepatic resection is a safe and effective procedure for treating hepatolithiasis. If possible, bypass procedures such as hepaticoenterostomy should be avoided to reduce postoperative complications.
