Clinical Application And Meta-analysis Of Precise Hepatectomy Techniques In The Treatment Of Hepatolithiasis

Objective: To explore the curative effect of precise hepatectomy techniques inhepatolithiasis．Methods: March2006to February2014about treatment of hepatolithiasis underwentprecise hepatectomy （32cases） and traditional hepatectomy （27cases） wereretrospectively analyzed， and the intraoperative and postoperative indexes such asoperation time，blood loss，transfusion rate，postoperative complications，hospitalizationtime，clearance rate of calculus were analyzed. And literature of case-controlled trials,published between May2007to February2014in both Chinese and English, comparingthe influences between precise hepatectomy and traditional hepatectomy efficacy intreatment of hepatolithiasis were collected, and the related parameters were evaluatedusing meta-analysis.Results: Compared with the patients in traditional hepatectomy group，although theoperative time was longer precise hepatectomy group(P=0.015)，but the patients precisehepatectomy group had less blood loss(P=0.001)，lower transfusion rate（P=0.026），lesspostoperative complications(P=0.005)，and higher clearance rate of calculus(P=0.013)，shorter hospital stay（P=0.027）. Thirteen studies were finally included in Meta-analysis, involving a total of1208patients, of whom,654cases underwent precise hepatectomy surgery (precise group)and554cases underwent traditional hepatectomy surgery (traditional group). The precisehepatectomy group compared with traditional surgery group, the operative time wasprolonged（WMD=49.36，CI=29.11~69.62，P<0.05）；while the intraoperative blood losswas reduced（WMD=-138.33%，CI=-164.01~-112.66，P<0.05）；lower transfusion rate（WMD=0.59%， CI=0.43~0.83， P<0.05)； higher clearance rate of calculus（WMD=1.20%，CI=1.14~1.26，P<0.05)；length of postoperative hospital stay（WMD=-5.83%，CI=-6.87~-4.80，P<0.05）and incidence of postoperative complications weredecreased（WMD=0.66%，CI=0.52~0.84，P<0.05).Conclusion: Precise hepatectomy was more satisfactory than traditional hepatectomy in the treatment of hepatolithiasis.