ABSTRACT
Objective To summarize the experience in operation manner and surgical technique of refractory cholelithiasis.Methods A total of five hundred and twenty one patients with refractory cholelithiasis admitted to Hunan Provincial People's Hospital from Jan.1990 to Dec.2007 were involved in this study for retrospective analysis.Results All patients in this group accepted surgery.Apart from three cases of perioperative death with liver and kidney failure,the remaining five hundred and eighteen cases had no serious complications,were cured and discharged.The imaging examination showed residual stone in seventy cases,accounting for fifteen percent.Four hundred and twenty one patients were followed up.The mean time of follow-up was seven years and six months (range 5 months - 17 years).Good result rate was 90.1%(381/423).Conclusions Most intractable cholelithiasis can be cured radically.Individual surgery programme,fine and standard surgical procedure are the key to treatment effect.
ABSTRACT
Objective To assess the causes and methods of surgical treatment of hepatolithiasis reoperation Methods The clinical data of 81 cases of hepatolith reoperation were analyzed retrospectively. Results The main causes of hepatolith reoperation include biliary stricture,biliary tract variation,cholangiocarcinoma, etc. The chief reoperation patterns were hepatic lobectomy, Roux-en-Y hepaticojejunostomy, and lobectomy combined with Roux-en-Y hepaticojejunostomy.A follow-up of 2 months to 12 months showed excellent (outcome) of 93.8% of cases. According to postoperative cholangiograph,the retained stone rate was 6.2%. Conclusions When treating cholelithiasis ,we should follow the following principles: remove stones, relieve biliary stricture, correct biliary variation, resect abnormal liver, and establish adeguate biliary drainage.