Modern Surgical Treatment Of Intrahepatolithiasis (Report Of 127 Cases)

Objective: To analyze the results of different operations for intrahepatobi1iary tract stones.Methods: one hundred and twenty-seven cases of intrahepatolithiasis treated in the hospital from January 2005 to January 2007 were summarized and analyzed retrospectively,all the cases were classified by the guide of the diagnosis and treatment for intrahepatolithiasis in 2007,and they were treated by the following surgical procedures:regular hepatolobectomy, hepatolobectomy plus cholangiohepati- cojejunostomy,high Cholangiohepaticojejunostomy, choledochostomy etal.Results:127 patients with intrahepatolithiasis were classified into three types:regional type(typeⅠ): 21 cases suffered hepatic duct stones in the left (16.5%), 9 cases in right (7.1%); diffusible type (typeⅡ): 18 cases had hepatic duct stones in both sides(14.2% );additional type(typeⅢ): 89 cases were joint extrahepatic cholelithiasis (70.1%)., 43 patients had the complication of biliary tracts stricture(33.8%), 13 patients were associated with biliary cirrhosis (10.2% ),and 4 patients were hepatocholangiocarcinoma suffers(3.1% )。21 cases underwent choledochostomy and T-Tube insertion,94 cases underwent regular hepatolobectomy( 8 cases plus cholangiohepaticojejunostomy) According to the Roux-en-y technique),12 cases with biliary tracts stricture were widely incised at the affected part and underwent cholangiohepaticojejunostomy。13 cases had postoperative bile duct retained stones(10.24% ),15 cases had postoperative complications (11.8% ),of them 3 fatal cases(2.36%).Conclusions: It is suggested that regular hepatolobectomy is an ideal procedure in the operation approaches to intrahepatolithiasis , Cho1angioscopy may play an important role in treatment of intrahepato—biliary tract stones.