ABSTRACT
Objective To evaluate the surgical treatment of splitting right hepatic duct with hepatolithiasis and stenosis. Methods The clinical data of 38 patients with splitting right hepatic duct and hepatolithiasis treated by operation were analyzed retrospectively. Results All the patients underwent operation. operative procedures were as follows: (1) in situ cholangioplasty of splitting right hepatic duct in 7 cases;(2) fenestration of splitting right hepatic with adjacent hepatic duct in 9 cases; (3) bilioplasty of splitting right hepatic duct with adjacent bile duct in 8 cases; (4) hepatic lobectomy or segmentectomy of splitting right hepatic duct in 14 cases. Postoperative complications developed in 6 cases, which were cured conservatively. There was no perioperative mortality. All patients were followed up for 5～16 years(averaged 9.2 years). Excellent rate was 78.9%,and residual stones were found in 26.3% of the patients . Conclusions Accurate localization and appropriate operation may get satisfactory result in treating patients with splitting right hepatic duct with hepatolithiasis and stenosis.
ABSTRACT
Objective To investigate the diagnosis and treatment of refluxing cholangitis.Methods Clinical data of 60 patients with refluxing cholangitis treated by surgery in recent 7 years in our hospital were reviewed retrospectively.Of the 60 patients,spontaneous refluxing cholangitis and iaotrogenic refluxing cholangitis ocurred in 42 and 18 patients respectively.Results Postoperactive complications occurred in 13 cases,including biliary fistula in 6 cases,incision infection in 2,intestinal obstruction in 2,subphrenic abscess in 2, all the complications were cured by various treatment.There was no perioperative mortality in this series.Fifty-five patients were followed-up for 2-11 years,42 were excellent,9 good and 2 poor;2 patients died of cerebral haemorrhage and myocardial infarction respectively during the follow-up period.Conclusions An appropriate operation should be chosen for patients with refluxing cholangitis according to the basic disorder and the extent of biliary duct wall deficit.
ABSTRACT
Objective To evaluate the procedure of surgical treatment of intrahepatic biliary calculi with blood vessel variation in hepatic hilus. Method The clinical data of 57 patients with intrahepatic biliary calculi and blood vessel variation in hepatic hilus treated by biliary operation were retrospectively analyzed.Results The simply biliary operation was performed on 13 cases ; variant blood vessels were cut off and ligated in 14 cases;The bile duct and blood vessel across conversion operation were performed on 22 cases;and the intrahepatic cholangiojejunostomy was carried out in 8 cases. There were no severe postoperative complications and perioperative mortality.51 patients(89.6%) were followed up for 4 to 15 years with the exellent results in 43(84.3%)cases. There were residual stones in 7 cases,of them,5 patients had intermittent abdominal pain in the right upper quadrant; reoperation was performed on another 2 cases because of recurrent cholangitis. One died of variceal bleeding 1.5 years after operation. Conclusions In order to accomplish the complex operations of biliary tract and avoid ischemic damage of liver, proper operation should be chosen for patients with intrahepatic biliary calculi with blood vessel variation in hepatic hilus.