Anatomic hepatectomy and lithotomy of liver parenchyma for regional hepatolithiasis / 中华普通外科杂志

ABSTRACT

Objective To evaluate anatomic hepatectomy (AH) vs lithotomy of liver parenchyma (LLP) for regional hepatolithiasis.Methods From January 2012 to June 2015,fifty-nine cases underwent LLP and 47 received AH.Clinical end-points included residual stones,infection of the raw surface of liver remnant,time to restoration of liver function,bile leakage,recurrent stones,morbidity and mortality.Results The time of liver function restoration was not statistically different between the two groups (2.96 d vs.2.82 d,P ＞0.05).Patients in AH group suffered from less residual stones (2 cases vs.13 cases,P ＜0.01),lower infection rate of the raw surface of liver remnant (1 case vs.21 cases,P ＜ 0.01),and less bile leakage rate (0 case vs.7 cases,P ＜ 0.05).With a median follow-up of 31 months (range 3-48 mon).AH group suffered from less recurrent hepatolithiasis (0 case vs.12 cases,P ＜ 0.01).There was no mortality in both groups.Conclusions Anatomic hepatectomy is a safe and effective treatment for hepatolithiasis,with a high stone clearance rate and low surgical complications.