New Surgical Technique for Hepatolithiasis: Ventral Hilar Exposure Method

ABSTRACT

PURPOSE: Various treatments have recently been applied for hepatolithiasis and their results also have been reported. We introduce herein a new surgical technique, the Ventral Hilar Exposure Method, for hepatolithiasis. This method has been performed for the last ten years at our hospital, and we now report the results of this procedure. METHODS: We evaluated the outcomes of 128 patients among 153 patients who had received hepatectomy with the method of ventral hilar exposure for hepatolithiasis at our hospital from June 1994 to June 2004. We analyzed the rates of residual and recurrent stone, the risk of the treatment and the rate of concomitant cholangiocarcinoma. With these results, we evaluated the utility of the ventral hilar exposure method for hepatolithiasis. RESULTS: There was no post-operative mortality and severe complications in the 128 patients who had received hepatectomy by the ventral hilar exposure method. Among those patients, the rate of residual stone and recurrent stone were 5.4% and 4.2%, respectively. The rate of concomitant cholangiocarcinoma was 11%. CONCLUSION: The ventral hilar exposure method hepatectomy is safe and it shows a more improved treatment result for hepatolithiasis. We think that the direct exploration of intra-hepatic hilar bile duct structure during hepatectomy resulted in the improved outcomes. Therefore, we recommend this procedure of hepatectomy as a standardized surgical treatment method for hepatolithiasis.