Comprehensive Treatment Of Intrahepatolithiasis

Objective: To analyze the results of comprehensive treatment of intrahepa- tolithiasis.Methods: one hundred and forty-five cases of intrahepatolithiasis treated in the First Hospital of Jilin University from January 2006 to August 2009 were summarized and analyzed retrospectively, and all the cases were treated by the following surgical procedures: choledochostomy, regular hepatolobectomy, Roux-en-Y cholangiohepaticojejunostomy, hepatolobectomy plus cholangiohe- paticojejunostomy, etal, with the application of choledochoscopy during or after operations, and taking traditional Chinese medicine after operations. The statistical method is used in the data analysis.Results: 73 cases underwent choledochostomy and T-Tube drainage, 60 cases underwent regular hepatolobectomy (3 cases plus cholangiohepa- ticojejunostomy), 12 cases underwent Roux-en-Y cholangiohepaticojejunostomy. 23 cases had postoperative bile duct retained stones(15.86%), 22 cases had postoperative complications(15.17%), of them 1 fatal cases(0.69%). The ratio of bile duct retained stones of the partial hepatectomy was lower than that of the choledochostomy(P<0.05), but the ratio of stones recurrence was not different between them(P>0.05); In the patients of choledochostomy, there were no differences between the laparoscopic and the open in the ratio of bile duct retained stones(P > 0.05); according to the numbers of choledochoscope application during the patients with retained stones, there were differences between the traditional Chinese medicine taking and the non-taking; during the patients with no retained stones, whether the choledochostomy or the partial hepatectomy, the ratio of stones recurrence of the traditional Chinese medicine taking is lower than the non-taking. During the follow-up, Excellent rate of all patients was 95%.Conclusion: during the treatment of intrahepatolithiasis, we could choose the comprehensive treatment with operations, intraoperative and postoperative choledochoscope application, and taking the traditional Chinese medicine.