Analysis of left hepatolithiasis treated with cranial-dorsal approach laparoscopic anatomic left hemihepatectomy
10.3760/cma.j.cn113884-20230105-00006
- VernacularTitle:经头背侧入路腹腔镜解剖性左半肝切除术在治疗左肝内胆管结石中的应用
- Author:
Zhi LIU
1
;
Xianbo SHEN
;
Lixue ZHOU
;
Jun WANG
;
Bingzhang TIAN
Author Information
1. 湖南省人民医院（湖南师范大学附属第一医院）肝胆外科，长沙 410005
- Keywords:
Laparoscopy;
Cranial-dorsal approach;
Left hemihepatectomy;
Hepatolithiasis
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(6):434-437
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and feasibility of anatomic left hemihepatectomy via cranial-dorsal approach in the treatment of left hepatolithiasis.Methods:Clinical data of 47 patients with left intrahepatic bile duct stones who underwent cranial-dorsal approach laparoscopic anatomic left hemihepatectomy in Hunan People's Hospital from October 2016 to June 2022 were retrospectively analyzed, including 15 males and 32 females, aged (56.45±1.37) years old. The operative time, intraoperative blood loss, postoperative liver function and complications were analyzed. Patients were followed up by telephone and outpatient review.Results:All 47 patients successfully underwent laparoscopic surgery without conversion. The median operative time was 260 (range, 160-440) min. The median intraoperative blood loss was 100 ml (range, 20-400 ml). The total bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were 15.7 (11.7, 21.9) μmol/L, 126.6 (91.7, 168.5) U/L, and 151.1 (98.0, 212.4) U/L on postoperative day (POD) 1, respectively, and decreased to 12.6 (9.6, 16.2) μmol/L, 97.9 (60.7, 156.9) U/L, 54.2 (40.0, 104.1) U/L on POD 3, respectively. The median postoperative hospital stay was 7 (range, 4-24) d. Postoperative abdominal effusion and infection occurred in one patient, and the complication rate was 2.1% (1/47). Postoperative CT review found residual stones in common bile duct in one patient [2.1% (1/47)]. No stone recurrence or death occurred during postoperative follow-up.Conclusion:Anatomic left hemihepatectomy via cranial-dorsal approach is a safe and feasible surgery for the treatment of left hepatolithiasis.
