Clinical Application Of Left Hepatectomy With Hepatolithiasis Guided By Liver Fibrosis Border

OBJECTIVE:To observe the clinical effects of left hepatectomy with hepatolithiasis guided by liver fibrosis border and anatomical left hepatectomy with hepatolithiasis guided by the ischemic line.Methods:Forty-five patients with hepatolithiasis treated in our hospital from June 2016 to June 2017 were randomly divided into two groups,left hepatectomy with hepatolithiasis guided by liver fibrosis border(experimental group)and anatomical left hepatectomy with hepatolithiasis guided by the ischemic line(conventional group).23 cases in the experimental group and 22 cases in the conventional group.Pringle blockade was used for block the blood after severing left hepatic artery and the left portal vein in both groups,The experimental group implements the left hemihepatectomy with hepatolithiasis guided by liver fibrosis border,Conventional group implements anatomical left hepatectomy with hepatolithiasis guided by the ischemic line.The patients in both groups were compared with thetotal bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and albumin(ALB),operation time,intraoperative bleeding,Middle hepatic vein exposure,postoperative ambulation,postoperative intestinal function recovery time,postoperative eating time,postoperative hospital days and postoperative pain and other indicators on the last 1 day before operation,on the 1 st day and the 5th day after operation.Results:The two groups of patients were successfully completed surgery,postoperative recovery were good.T-tube Cholangiography confirmed the absence of residual stones after 2 months later.Comparing with thetotal bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and albumin(ALB)on the last 1 day before operation,on the 1st day and the 5th day after operation,there is no significant difference between the two group(P>0.05).There is no significant difference with the Middle hepatic vein exposure between the two groups(P>0.05).In the operation time,intraoperative bleeding,the data suggest that there is statistical differences between the two groups(P<0.05);The postoperative ambulation,postoperative intestinal function recovery time,postoperative eating time,postoperative hospital stay,Postoperative pain and other aspects of the two groups showed no significant difference(P>0.05).CONCLUSIONS:The left hepatectomy with hepatolithiasis guided by liver fibrosis border is safe and effective.The left hepatectomy with hepatolithiasis guided by liver fibrosis border based on the hepatic blood flow control technique of anatomical hepatectomy,relative tothe characteristics of hepatolithiasis lesions,maybe has a better clinical value in the left hepatectomy with significant hepatic atrophy and fibrosis in hepatolithiasis.