Effectiveness of hepatic parenchyma lithotomy of hepatolithiasis

Abstract

To investigate the clinical significance of hepatic parenchyma incision by lithotomy near the second hepatic portal area for the treatment of complex hepatolithiasis.A retrospective study was conducted with 35 patients who had complicated hepatolithiasis in our hospital from January 2008 to December 2013, who underwent hepatic parenchyma incision by lithotomy near the second hepatic portal area. The perioperative and long-term outcomes included the stone clearance rate, operative morbidity and mortality, and the stone recurrence rate. Patients with a preoperative diagnosis of cholangiocarcinoma were excluded from the study.All patients with hepatic duct stones were mainly located at S2, S4, and S8 regions. Surgical methods included were hepatic parenchyma incision by lithotomy near the second hepatic portal area, or by combined partial hepatectomy. The mean follow-up period was 51 months. One patient died during hospitalization. The surgical morbidity was 17.6%, stone clearance rate was 88.2%, and final clearance rate was 94.1% followed by postoperative choledochoscopic lithotripsy. The stone recurrence rate was 15.6% and the occurrence of postoperative cholangitis was 11.8% during the follow-up period.Hepatic parenchyma incision by lithotomy near the second hepatic portal area is safe with satisfactory short and long-term outcome results for complicated hepatolithiasis.

Intrahepatic bile duct exploration lithotomy is a useful adjunctive hepatectomy method for bilateral primary hepatolithiasis: an eight-year experience at a single centre

“…Our previous study found that IHBD exploration lithotomy for complex IHBD stones achieved satisfactory results [4]. To this end, this study used IHBDIL combined with partial hepatectomy for the treatment of complicated bilateral hepatolithiasis to further assess the safety and efficacy of this treatment method.…”

Abound Hepatic Mitosis: Unusual Morphology in the Intrahepatic Cholelithiasis Patient

“…SABC dilution 100x. (10) Remove the slide from the incubator and wash it in PBS for 3 times, each time 5 mins, dry the PBS around the tissue and add a chromogenic agent. (11) After rinsing the colored slides with clean water for a period of time, soak them in hematoxylin and dye them.…”

“…Combined with intraoperative ultrasound to accurately locate bile duct lesions and the extent of stones, the focus can be effectively removed, and the stone clearance rate is up to 95%. However, the postoperative recurrence rate is still as high as 3% to 15% [8][9][10] . The main reason is that (1) improper application of operation.…”