Efficacy comparison of precise and traditional liver resection in treatment of intrahepatic bile duct stones / 临床肝胆病杂志

ABSTRACT

ObjectiveTo compare the efficacy of precise and traditional liver resection in the treatment of intrahepatic bile duct stones. MethodsOne hundred and twenty-seven patients with intrahepatic bile duct stones who were treated with surgery in our hospital from December 2008 to December 2014 were selected and divided into precise liver resection group (n=72) and traditional liver resection group (n=55) based on the type of surgery. The operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, postoperative complications (incision infection, biliary fistula, lung infection, and pleural effusion), hospitalization cost, postoperative residual calculi, and postoperative calculus recurrence were compared between the two groups. Between-group comparison of continuous data was made by t test, and between-group comparison of categorical data was made by χ2 test. Survival data were analyzed using survival function. ResultsThere were significant differences in operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, and hospitalization cost between the precise liver resection group and the traditional liver resection group (t=3.720, 58.681, 19.169, 5.990, and 6.944; all P＜0.05). There were no significant differences in postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion between the two groups (all P＞0.05). There were also no significant differences in the incidence rates of postoperative residual calculi and calculus recurrence between the two groups (all P＞0.05). The survival analysis of postoperative calculus recurrence time showed that there was no significant difference in calculus recurrence time between the two groups (P＞0.05). ConclusionCompared with traditional liver resection, precise liver resection has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and faster recovery; however, precise liver resection raises hospitalization cost. Moreover, precise liver resection does not increase the risks of postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion; however, it does not reduce the incidence rates of postoperative residual calculi and calculus recurrence.