Analysis Of Hepatolithiasis With Hepatic Resection In 41 Cases

ObjectiveTo investigate the hepatic resection of intrahepatic bile duct stones and the efficacy of a reasonable surgical.MethodsFrom February 2004 to February 2008 our group treated 41 patients of hepatolithiasis with liver resection. According to the distribution of stones and intraoperative specific purposes they were treated differently in the liver segment (lobe) resection and ways of drainage, combined with intraoperative and postoperative cholangioscopy.ResultsThese patients were followed up 2 to 6 years after operation. Excellent result in 32 cases (78.0%), good in 5 cases (12.2%) and poor in 4 cases (9.8%). Postoperative residual stones in the final three cases (7.3%). The recurrence rate was 7.3%, and re-operation rate 9.8%, due to residual or recurrent stones in 4 cases, The incidence of complications after operation was 9.8%, including subphrenic abscess in 1 case, wound infection in 1 case, subcutaneous fat liquefaction in 1 case and T tube extrusion biliary with fistula in 1 case, who were all cured by non-surgical treatment. No operative mortality occurred.Conclusionhepatic segment (lobe) resection combined with rational T-tube drainage, or biliary-enteric anastomosis drainage in the treatment of hepatolithiasis works well. The application of intraoperative cholangioscopy can reduce the residual stone rate of surgery. Reasonable surgical options and norms of medical operation can improve efficacy, reduce complications and lower recurrence rate and re-surgery rate. Cholangioscopy plays an important role in treatment of postoperative residual bile duct stones.