Effects Analysis Of Anatomical Hepatectomy For Hepatolithiasis

Objective To compare the effects of anatomical and nonanatomical regular hepatectomy for Hepatolithiasis.Methods From February 2008 to June 2014,168 cases of liver resection in treatment of patients with hepatolith in Anhui provincial hospital. There were 110 patients with hepatolithiasis underwent traditional nonanatomic regular hepatectomy,and the other 58 patients with hepatolithiasis were underwent anatomical regular hepatectomy. The operation time, intraoperative blood loss, liver resection blood loss, incidence of postoperative complications, the third day postoperative liver function level, length of postoperative hospitalization, spend of hospitalization, residual stone rate and recurrence rate of the two groups were compared.Results There were no significant differences in the general condition, basic diseases, stone distribution, anatomic variation and scope of liver resection between the two groups before operation(P>0.05). There were no perioperative death of the two groups, all the patients were told to review after discharge from 1 to 7 years. The operation time was 288.11±66.78 min, intraoperative blood loss was 402.86 ±329.09 ml, liver resection blood loss was 158.17 ± 87.9 ml, the third postoperative day ALT was 169.41±68.26 IU/L, TB was 58.12±13.45 umol/L, ALB was 30.33±7.89 g/L, six patients of complications(including 2 cases of bile leakage, 3 cases of pleural effusion, 1 case of incision infection), length of postoperative hospitalization was 7.63 ± 3.52 days, the hospital total cost is 29466±10494 yuan, 2 patients with residual stones and 1 patients with recurrence of the anatomic regular hepatectomy groups. The operation time was 198.11±56.89 min, intraoperative blood loss was501.78±288.12 ml, liver resection blood loss was 188.11±78.2ml, the third postoperative day ALT was 211.52±78.26IU/L, TB was 61.32±15.11umol/L, ALB was 28.01±6.12g/L, thirty-two patients of complications(including 16 cases of bile leakage, 12 cases of pleural effusion, 1 case of abdominal bleeding and 3 case of incision infection), length of postoperative hospitalization was 8.82±4.14 days, the hospital total cost is 28466±10899 yuan, 20 patients with residual stones and 18 patients with recurrence of the nonanatomic regular hepatectomy groups. The intraoperative blood loss, liver resection blood loss, the third postoperative day ALT, incidence of postoperative complications, residual stone rate and recurrence rate was significantly reduced but the operative time was significantly pronlonged in ananomic regular hepatectomy group compared with nonanatmoic hepatectomy group(P<0.05). No differences between the two groups were noted with regard to the length of postoperative hospitalization, spend of hospitalization, the third postoperative day TB and ALB level(P>0.05).Conclusion The anatomical regular hepatectomy can remove stones and lesions completely, reduce the residual rate of the stones and the recurrence and reduce the incidence of postoperative complications. Although it currently requires longer operative time and difficult technology than nonanatomical regular hepatectomy, it deserves to be widely performed.