Experience of right hemihepatectomy for treatment of hepatolithiasis in the right or both lobes / 第二军医大学学报

ABSTRACT

Objective: To summarize our experience on right hemihepatectomy for treatment of hepatolithiasis. Methods: The clinical data of thirty-nine patients suffering from intrahepatic bile duct stones, who had undergone right hemihepatectomy in our hospital from Jan. 2000 to Dec. 2006, were retrospectively analyzed. The outcomes of operation, complication, and the follow-up findings were analyzed; and the clinical experience was summarized. Results: The 39 patients included 8 males and 31 females, with an age range of 23-65 years old and a mean of (44.2 ± 10.5) years old. All patients had various degrees of hepatobiliary stricture. All cases underwent right hemihepatectomy plus eholedoehotomy and T-tube drainage, including 28 also had cholecystectomy, 1 had additional left lateral hepatectomy, 1 had choledoehocystomy plus hepatojejunostomy, and 1 had demolishment of anastomotie stoma of choledochoduodenostomy. The post-operation complications included pleural effusion (17.9%), subphrenic infection (12.8%), liver failure (7.7%), biliary fistula (5.1%), and infection of incisional wound (5.l%). Two patients (5.1%) died of liver failure during the hospital stay. One was indicated of having intrahepatic cholangiocarcinoma and died of recurrence of cholangiocarcinoma 6 months after operation. Thirty-six patients (92.3%) received long-term follow-up (a median of [42.5±2.5] months) and 34 (94.4%) of them were symptom free. Excellent outcomes were achieved in the 31 patients with isolated right intrahepatic bile duct stones. Conclusion: Right hemihepatectomy is effective for right hepatolithiasis, especially for patients combined with right hepatic duct stricture. However, it should be noted that the operation is very difficult and has many complications, so the indications and contraindications of right hemihepatectomy should be strictly selected.