Clinical Application on Hepatectomy Combined with Biliary Tract Exploration via The Bile Duct Stump in Treatment of Hepatolithus_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HUANGZhi , PENGSha-sha , DUANJian , HUANGHan-fei , LINJie , SUZi-ting ,  ZENGZhong

Organ Transplantation Center, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China;

Corresponding?author：

ZENGZhong, Email: zzong@medmail.com.cn

Keywords：

Hepatolithiasis; Common bile duct incision; Choledochoscopic exploration; Left hepatic lobectomy

DOI：

10.7507/1007-9424.20140287

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the feasibility and effect of treatment of bile duct exploration though hepatic sections instead of spliting common bile duct, cured for hepatolithiasis with bile duct stones. Methods Clinical data of 122 cases of our hospital were retrospectively reviewed, these patients with left intrahepatic bile duct stone and common bile duct calculi. As control group, during the period from June 2007 to June 2010, in which 64 patients underwent left hepatic lobectomy, common bile duct exploration and T tube drainage. In observation group, 58 patients from June 2011 to December 2013, underwent left hepatic resection combined biliary duct exploration by the liver section stump bile duct. The operative time, intraoperative bleeding volume, postoperative hospitalization time, and incidence of complications between the 2 groups were compared. Results Compared with the control group, the postoperative hospitalization time was shortened obviously in observation group patients(P < 0.05), there were no significant difference in operative time and bleeding during operation of 2 groups(P > 0.05), The incidence of postoperative complications in the observation group was significantly lower than the control group(P < 0.05). In 122 patients, 105 cases were followed-up(86.1%), the follow-up time was 2 years. Two groups of patients had no stone residual and recurrence. Conclusions Bile duct exploration by intraoperative liver section is an effective method to treat left hepatolithiasis, it can simplified procedures, shortening the postoperative hospitalization time, and effectively avoid complications caused by common bile duct incision and T tubedrainage.

Citation： HUANGZhi, PENGSha-sha, DUANJian, HUANGHan-fei, LINJie, SUZi-ting, ZENGZhong. Clinical Application on Hepatectomy Combined with Biliary Tract Exploration via The Bile Duct Stump in Treatment of Hepatolithus. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1194-1197. doi: 10.7507/1007-9424.20140287 Copy

1.	Agarwal N, Sharma BC, Garg S, et al. Endoscopic management of postoperative bile leaks[J]. Hepatobiliary Pancreat Dis Int, 2006, 5(2):273-277.
2.	Tazuma S. Gallstone disease:epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic)[J]. Best Pract Res Clin Gastroenterol, 2006, 20(6):1075-1083.
3.	Sato M, Watanabe Y, Horiuchi S, et al. Long term results of hepatic resection for hepatolithiasis[J]. HPB Surg, 1995, 9(1):37-41.
4.	Cheung MT, Kwok PC. Liver resection for intrahepatic stones[J]. Arch Surg, 2005, 140(10):993-997.
5.	Uchiyama K, Kawai M, Ueno M, et al. Reducing residual and recurrent stones by hepatectomy for hepatolithiasis[J]. J Gastrointest Surg, 2007, 11(5):626-630.
6.	黃志強, 黃曉強, 張文智, 等.肝切除術治療肝內膽管結石20年的演變[J].中華外科雜志, 2008, 46(19):1450-1452.
7.	Sikic N, Tutek Z, Strikic N. Primary suture vs. T-tube after common bile duct exploration (our 25 years of experience)[J]. Przegl Lek, 2000, 57(5):143-145.
8.	Haq A, Morris J, Goddard C, et al. Delayed cholangitis resulting from a retained T-tube fragment encased within a stone:a rare complication[J]. Surg Endosc, 2002, 16(4):714.
9.	徐云峰, 王凱, 劉亞奇, 等.原發性肝內膽管結石合并膽管癌[J].中華普通外科雜志, 2012, 27(2):145-147.
10.	Park HS, Lee JM, Kim SH, et al. CT Differentiation of cholangiocarcinoma from periductal fibrosis in patients with hepatolithiasis[J]. AJR Am J Roentgenol, 2006, 187(2):445-453.
11.	Kayhan B, Akdogan M, Parlak E, et al. Hepatolithiasis:a Turkey experience[J]. Turk J Gastroenterol, 2007, 18(1):28-32.
12.	Kim YT, Byun JS, Kim J, et al. Factors predicting concurrent cholangiocarcinomas associated with hepatolithiasis[J]. Hepatogastroenterology, 2003, 50(49):8-12.
13.	董家鴻, 黃志強, 蔡景修, 等.規則性肝段切除術治療肝內膽管結石病[J].中華普通外科雜志, 2002, 17(7):418-420.
14.	黃志強.肝內膽管結石外科治療的進展[J].中國實用外科雜志, 2004, 24(2):65-66.
15.	Poon RT, Fan ST, Lo CM, et al. Improving perioperative outcome expands the role of hepatectomy in management of benign and malignant hepatobiliary diseases:analysis of 1222 consecutive patients from a prospective database[J]. Ann Surg, 2004, 240(4):698-708.
16.	Lee SG, Hwang S. How I do it:assessment of hepatic functional reserve for indication of hepatic resection[J]. J Hepatobiliary Pancreat Surg, 2005, 12(1):38-43.
17.	楊一屯, 陳小偉, 楊森華, 等.肝膽管結石280例外科治療的變遷[J].中華肝膽外科雜志, 2003, 10(2):65-68.
18.	Hwang S, Lee SG, Kim MH, et al. Intraoperative biliary exploration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis[J]. Langenbecks Arch Surg, 2008, 393(3):383-389.
19.	譚志健, 何軍明, 鐘小生, 等.肝外段肝靜脈的控制與選擇性肝血流阻斷在肝切除術中的運用[C]//第五屆中西醫結合圍手術期醫學研討會論文集.杭州, 2010:79-82.
20.	董玉璽, 李德旭, 金俊碩, 等.選擇性肝血流阻斷法在切肝術中應用研究[J].中華實用診斷與治療雜志, 2014, 28(3):244-255.
21.	王德盛, 竇科峰, 高志清.復雜性肝內膽管結石的外科綜合治療[J].中華肝膽外科雜志, 2004, 10(4):273-274.
22.	梁力建, 李紹強.復雜肝膽管結石診斷和治療原則[J].中國實用外科雜志, 2009, 29(7):542-544.
23.	Kim MJ, Michell DG, Ito k, et al. Billiary dilatation:differentiaion of benign from malignant causes value of adding conventional MR imaging tom MR cholangiopancreatography[J]. Radiology, 2000, 214(1):173-181.
24.	Sica GT, Brarer J, Cooney MJ, et al. Comparison of endoscopic retrograde cholangiopancreatography with MR cholangiopancreatography in patients with pancreatitis[J]. Radiology, 1999, 210(3):605-610.
25.	陳照宏, 陳志安. MRCP對復雜型膽道結石的診斷價值[J].醫學影像學雜志, 2013, 23(3):434-436.

1. Agarwal N, Sharma BC, Garg S, et al. Endoscopic management of postoperative bile leaks[J]. Hepatobiliary Pancreat Dis Int, 2006, 5(2):273-277.
2. Tazuma S. Gallstone disease:epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic)[J]. Best Pract Res Clin Gastroenterol, 2006, 20(6):1075-1083.
3. Sato M, Watanabe Y, Horiuchi S, et al. Long term results of hepatic resection for hepatolithiasis[J]. HPB Surg, 1995, 9(1):37-41.
4. Cheung MT, Kwok PC. Liver resection for intrahepatic stones[J]. Arch Surg, 2005, 140(10):993-997.
5. Uchiyama K, Kawai M, Ueno M, et al. Reducing residual and recurrent stones by hepatectomy for hepatolithiasis[J]. J Gastrointest Surg, 2007, 11(5):626-630.
6. 黃志強, 黃曉強, 張文智, 等.肝切除術治療肝內膽管結石20年的演變[J].中華外科雜志, 2008, 46(19):1450-1452.
7. Sikic N, Tutek Z, Strikic N. Primary suture vs. T-tube after common bile duct exploration (our 25 years of experience)[J]. Przegl Lek, 2000, 57(5):143-145.
8. Haq A, Morris J, Goddard C, et al. Delayed cholangitis resulting from a retained T-tube fragment encased within a stone:a rare complication[J]. Surg Endosc, 2002, 16(4):714.
9. 徐云峰, 王凱, 劉亞奇, 等.原發性肝內膽管結石合并膽管癌[J].中華普通外科雜志, 2012, 27(2):145-147.
10. Park HS, Lee JM, Kim SH, et al. CT Differentiation of cholangiocarcinoma from periductal fibrosis in patients with hepatolithiasis[J]. AJR Am J Roentgenol, 2006, 187(2):445-453.
11. Kayhan B, Akdogan M, Parlak E, et al. Hepatolithiasis:a Turkey experience[J]. Turk J Gastroenterol, 2007, 18(1):28-32.
12. Kim YT, Byun JS, Kim J, et al. Factors predicting concurrent cholangiocarcinomas associated with hepatolithiasis[J]. Hepatogastroenterology, 2003, 50(49):8-12.
13. 董家鴻, 黃志強, 蔡景修, 等.規則性肝段切除術治療肝內膽管結石病[J].中華普通外科雜志, 2002, 17(7):418-420.
14. 黃志強.肝內膽管結石外科治療的進展[J].中國實用外科雜志, 2004, 24(2):65-66.
15. Poon RT, Fan ST, Lo CM, et al. Improving perioperative outcome expands the role of hepatectomy in management of benign and malignant hepatobiliary diseases:analysis of 1222 consecutive patients from a prospective database[J]. Ann Surg, 2004, 240(4):698-708.
16. Lee SG, Hwang S. How I do it:assessment of hepatic functional reserve for indication of hepatic resection[J]. J Hepatobiliary Pancreat Surg, 2005, 12(1):38-43.
17. 楊一屯, 陳小偉, 楊森華, 等.肝膽管結石280例外科治療的變遷[J].中華肝膽外科雜志, 2003, 10(2):65-68.
18. Hwang S, Lee SG, Kim MH, et al. Intraoperative biliary exploration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis[J]. Langenbecks Arch Surg, 2008, 393(3):383-389.
19. 譚志健, 何軍明, 鐘小生, 等.肝外段肝靜脈的控制與選擇性肝血流阻斷在肝切除術中的運用[C]//第五屆中西醫結合圍手術期醫學研討會論文集.杭州, 2010:79-82.
20. 董玉璽, 李德旭, 金俊碩, 等.選擇性肝血流阻斷法在切肝術中應用研究[J].中華實用診斷與治療雜志, 2014, 28(3):244-255.
21. 王德盛, 竇科峰, 高志清.復雜性肝內膽管結石的外科綜合治療[J].中華肝膽外科雜志, 2004, 10(4):273-274.
22. 梁力建, 李紹強.復雜肝膽管結石診斷和治療原則[J].中國實用外科雜志, 2009, 29(7):542-544.
23. Kim MJ, Michell DG, Ito k, et al. Billiary dilatation:differentiaion of benign from malignant causes value of adding conventional MR imaging tom MR cholangiopancreatography[J]. Radiology, 2000, 214(1):173-181.
24. Sica GT, Brarer J, Cooney MJ, et al. Comparison of endoscopic retrograde cholangiopancreatography with MR cholangiopancreatography in patients with pancreatitis[J]. Radiology, 1999, 210(3):605-610.
25. 陳照宏, 陳志安. MRCP對復雜型膽道結石的診斷價值[J].醫學影像學雜志, 2013, 23(3):434-436.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Application on Hepatectomy Combined with Biliary Tract Exploration via The Bile Duct Stump in Treatment of Hepatolithus

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content