Clinical Analysis Of Segmental Hepatectomy For Intrahepatolithiasis

Objectiv: To investigate the therapeutic effect of segmental hepatectomy for intrahepatolithiasis.Methods: From July 1992 to September 2008, The clinical data of the surgical therapy of 69 cases of hepatolithiasis received hepatectomy were analyzed restrospectively.The postoperative residual stone rate, outcome and morbidity were compared between the patients received hepatectomy and those underwent non-hepatectomy.There were 38 of the patients in this series underwent various types of hepatectomy. 31 patients were treated by operation without hepatic segmental resection.Results: There were 55. 07 % of the patients in this series underwent various types of hepatectomy. The percentage of patients undergoing hepatectomy during 2004--2008 was significantly higher than that during 1992--2003. No one died after operation.The patients receiving hepatectomy showed residual calculus rate was 7. 9 % , and symp toms recurrence rate 5. 26 %. No patient was operated again. Operative excellent and good result rate was 97. 23 %. Those undergoing non-hepatectomy showed residual calculus rate was 29. 03 % , and symp toms recurrence rate 25. 80 %. 5 cases received hepatectomy. Operative excellent and good result rate was 77. 41 %. The patients undergoing hepatectomy had less postoperative residual stone rate, higher rate of good outcome as compared with those receiving non-hepatectomy . However, there was no marker difference in the postoperative morbidty between the patients receiving hepatectomy and those undergoing non-hepatectomy. Eighty patients whose stones were localized at the left lateral lobe had no postoperative residual stone after left lateral segmentsctomy.Conclusio: Hepatectomy is the most effective and safe therapeutic method for hepatolithiasis with lower rate of residual stone and recurrence and enhance the excellent or good rate of effect .