Clinical study on curative effect of surgical treatment for hepatolithiasis
LI Xiaogui, WUYi, LU Jiayin, LI Hao, WANG Xintian
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital, Biliary Duct Disease Research Center of Hunan Provincial Health Commission, Changsha 410005, China
Abstract：Objective To investigate the surgical treatment of hepatolithiasis. Methods Retrospective analysis and summary were made of 658 cases of hepatolithiasis treated by our department of surgery from January 2019 to July 2022, and the characteristics of the cases and surgical methods were analyzed . Results Among the 658 cases, 306 cases (46.50%) underwent hepatic lobectomy, among which laparoscopic hepatic lobectomy accounted for 13.7%; biliary and intestinal drainage accounted for 52.58%; holmium laser accounted for 46.20%; percutaneous hepatic bile duct lithotripsy (percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) accounted for 6.69%. There was 1 death in the whole group, and 196 patients (29.79%) were found to have residual stones in postoperative CT scans, of which 63 patients (9.57%) underwent choledochoscopy for stone removal.19cases (2.89%) of complicated biliary tract infection occurred after operation, of which 2 case (0.31%) died after multiple organ failure due to severe infection, and the remaining 17 cases ( (2.58%) were treated with repeated bile culture to adjust antibiotics and other symptomatic cases improved after supportive treatment. There were 52 cases (7.90%) of postoperative bile leakage, all of which were self-limited after nutritional support therapy or ultrasound-guided intraperitoneal drainage. There were 50 cases (7.60%) of postoperative hemorrhage, of which 4 cases (0.61%) underwent laparotomy for hemostasis, 3 cases (0.46%) underwent interventional embolization for hemostasis, and the rest stopped bleeding after conservative treatment. Conclusion The disease of hepatolithiasis is complicated and personalized, which requires multi-departmental collaboration and combination of a variety of advanced technologies to formulate “individual” treatment plan for specific cases.
李小归, 吴意, 卢嘉胤, 李浩, 汪新天. 肝胆管结石病外科治疗方法疗效的临床研究[J]. 湖南师范大学学报(医学版), 2024, 21(1): 75-80.
LI Xiaogui, WUYi, LU Jiayin, LI Hao, WANG Xintian. Clinical study on curative effect of surgical treatment for hepatolithiasis. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(1): 75-80.
2024, Vol. 21 
