Clinical Effect Analysis Of Laparoscopic Hepatectomy For Left-side Hepatolithiasis

Objective: To evaluate feasibility of laparoscopic left hepatectomy for left side hepatolithiasis by comparison with open left hepatectomy for the same disease.Methods: to study the clinical data of 49 patients with left side hepatolithiasis repaired by open hepatectomy(OH group)in the First Affiliated Hospital of Fujian Medical University from January 2013 to December 2014 and clinical data of 48 patients with left side hepatolithiasis repaired by laparoscopic hepatectomy(LH group)in the First Affiliated Hospital of Fujian Medical University from January 2015 to 2016 December,the operative modes in the two groups included the left liver lateral lobe resection,left hemihepatectomy.The clinical indicators including the operation time,intraoperative blood loss,postoperative hospital stay time,stone clearance rate and recurrence rate were analyzed and compared between the two groups Results: All the 76 patients were operated successfully.there was no first hepatic portal inflow occlusion in LH group,there was one first hepatic portal inflow occlusion in OH group inflow occlusion time was 4 min.The operation time of LH group was(225±60.6)min,The operation time of OH group was(134.4±36.0)min,There was significant difference between the two groups.The intraoperative blood loss of LH group was(229.58±110.68)ml,The intraoperative blood loss of OH group was(218.37±118.45)ml min,There was no significant difference between the two groups.The postoperative hospital stay of LH group was 7.5(4)d,The postoperative hospital stay of OH group was 10(5)d,There was significant difference between the two groups.the time for removal of the abdominal cavity drainage tube of LH group was4(2)d,the time for removal of the abdominal cavity drainage tube of OH group was5(2)d,There was no significant difference between the two groups.There was no significant difference between the two groups in incidence rate of overall complications,bile leakage,postoperative bleeding,abdominal infection,bile infection and pulmonary infection.2 patients of LH group occurred postoperativebleeding,the incidence was 4.16%,and repaired by conservative treatment.2 patient of OH occurred postoperative bleeding,the incidence was 4.08%,and repaired by emergency reoperation,the difference was no statistically significant.no patients of LH group occurred incision infection,and repaired by conservative treatment.6 patient of OH occurred incision infection,the incidence was 12.24% and repaired by conservative treatment,the difference was statistically significant,There was no dead case during the perioperative period in the LH group,There was one dead case during the perioperative period in the OH group,the cause of death is Multiorgan dysfunction syndrome(MSOF),There was no significant difference between the two groups.Followed up for 3-44 months,with an average of 21.54 ±11.02 months,the short term calculus clearance of LH group was 77%,the short term calculus clearance of OH group was 71.1% There was no significant difference between the two groups.Conclusion: laparoscopic hepatectomy for treating left side hepatolithiasis is feasible with equal short-term therapeutic effect to that of open left hepatectomy.The operation time of LH was longer than OH group,but the postoperative hospital stay and the incidence rate of incision infection of LH is short than OH,reflecting its minimally invasive advantages and worthy of clinical application.