Laparoscopic Hepatectomy For Intra- And Extrahepatic Bile Duct Stones In 16 Cases

Objective To investigate the feasibility of laparoscopic resection of lateral lobe of left liver in the treatment of left intra- and extrahepatic bile duct stones.Methods From November, 2002 to October, 2004, our institute performed laparoscopic resection of lateral lobe of left liver on 16 patients of intra- and extrahepatic bile duct stone, 7 male and 9 female, the mean age was 47.2 years ( range from 36 to 69 ), of all the patients, 3 were intrahepatic bile duct stones of lateral lobe of left liver, 3 were intrahepatic bile duct stones lateral lobe of left liver with cholelithiasis, 2 were intrahepatic bile duct stones lateral lobe of left liver and common bile duct stones, 8 were intrahepatic bile duct stones lateral lobe of left liver with cholelithiasis and common bile duct stones. Result all the surgeries were completed laparoscopically,none converted to open, no blockage of hepatic portal vein. Of the 16 patients, 2 patients received resection of lateral lobe of left liver, 3 patients received resection of lateral lobe of left liver and and calculus removed by choledochoscope,. 3 patients received resection of lateral lobe of left liver, exploration of common bile duct, and calculus removed by choledochoscope, 8 patients received resection of lateral lobe of left liver, exploration of common bile duct, cholecystectomy and calculus removed by choledochoscope the mean operating time was 238 minutes and the mean blood loss was 430ml. the maximun bulk of the specimen was 10cm*9cm*7cm, one patient had bile leakage after operation and recoverd well after the second operation. No other complications. All the patients could walk 24 hours after operation and started on a normal diet 1 to 3 days after surgery. In the patients with T-tube, no residual stone was found by cholangiography after operation and the T-tube was removed 2 to 3 weeks after operation. Conclusions Laparoscopic resection of lateral lobe of left liver with exploration of common bile duct and calculus removed by choledochoscope was a effective and safe technique for the treatment of intra- and extrahepatic bile duct stones and should been widely adopted.