1. Surgical outcome evaluation and prediction analysis of laparoscopic left sided hepatectomy for hepatolithiasis
Linlong XU ; Zhigang HU ; Dongxiao YANG ; Shubing ZOU ; Kai WANG
Chinese Journal of Surgery 2019;57(7):527-533
Objective:
To explore the risk factors of long-term treatment outcomes and establish predicting model for laparoscopic left hepatectomy in hepatolithiasis.
Methods:
Clinical data of 108 patients with hepatolithiasis who underwent laparoscopic left sided hepatectomy and with complete follow-up data were retrospectively collected from June 2011 to June 2016 at the Second Affiliated Hospital of Nanchang University. Twenty-six males and 82 females were enrolled. The age was (52.4±11.7) years (range:20-80 years) , and the median follow-up time was 36 months (range: 24-83 months) . Patients were randomly divided into training group (79 cases) and validation group (29 cases) with a ratio of about 3∶1. Twenty-five preoperative and intraoperative clinical factors were selected for potential factors that might affect long-term outcomes, and quality of life was used as an surrogate evaluation index. Univariate analysis and multivariate logistic regression analysis were used to investigate the potential risk factors, and to construct and validate the predictive nomogram for surgical outcomes.
Results:
Among 108 patients, 10 patients (9.3%) had residual stones, 8 patients (7.4%) had recurrent stones, 12 patients (11.1%) had recurrent cholangitis and 3 patients (2.8%) died. Univariate analysis showed that history of hepatobiliary surgery, gender, activation of partial thromboplastin time, alkaline phosphatase, use of choledochoscopy, postoperative stone residual, serum creatinine, postoperative biliary drainage and operation time were risk factors that may affect long-term outcomes (all