Surgical treatment of caudate hepatolithiasis / 第二军医大学学报

ABSTRACT

Objective: To summarize our experience on surgical treatment of caudate hepatolithiasis, so as to improve the diagnosis and treatment of caudate hepatolithasis. Methods: The clinical data, mode of operation, post-operation complications, and follow up findings were retrospectively analyzed in 19 patients with caudate hepatolithasis from Jan. 2000 to Dec. 2006. Results: The 19 cases included 8 males and 11 females. Totally they had undergone 30 times of operation, with 12 cases only had once, 4 had twice, 2 had thrice, and 1 had 4 times. All cases received B ultrasound, CT, MRCP or ERCP and were confirmed to have caudate hepatolithiasis. Fourteen cases were complicated with opening stonosis of caudate bile duct. Eleven cases received caudate lobe resection. Eight cases received caudate expansion of the bile duct or plastic repair of duct + caudate duct exploration and calculus extraction, with a success rate of 100% and the patients were stone free after surgery. Eighteen patients (94.7%) were followed up for a mean of (17.6±2.3) months. Two cases had stone recurrence. The excellent and good rate was 88.9% in the present cohort; all those who received resection of the caudate lobe had excellent or good outcomes. Conclusion: It is very complex and difficult to treat caudate bile duct stone; caudate duct exploration and calculus extraction usually have unsatisfactory outcomes. Caudate lobe resection can clear the lesions and has a good long-term effect, which is largely dependent on the rich experience and the skillfulness of the surgeons.