Hepatic Resection for Intrahepatic Stones

Kim, Woon Weon; Oh, Sang Hoon; Choi, Young Kil

Abstract

The main objectives of the surgical treatment of intrahepatic stones are complete removal of the stones and correction of biliary stasis and strictures. Hepatic resection is expected to yield a most satisfactory treatment result by eradicating the stones and the strictured bile duct as well. To evaluate the effectiveness and the risk of hepatic resection, we reviewed 149 patients who underwent hepatic resection due to intrahepatic stones over a fourteen-year period and who were followed up. There were 48 males and 101 females, and ages ranged from 20 to 70 years. The stones were located in the left lobe in 96 patients, the right lobe in 13 patients, and both lobes in 40 patients. The operative procedures executed in the patients were 96 lateral segmentectomies, 33 left lobectomies, 14 right lobectomies, one extended right lobectomy, and five partial resections. Biliary drainage procedures were added in 40 patients. Postoperatively, retained stones were found in 24.2% of the patients which was lowered to 10.7% at the time of discharge with assistance of radiologic interventions. During follow-up over a mean period of 63 months, 93.2% of the patients showed good rehabilitation, and recurrent stones had developed in 5 patients (3.5%). Operative complications were biliay fistula in 10 patients, intra-abdominal abscess in seven patients, hepatic failure in two patients, and postoperative bleeding in one patient, and the overall operative mortality rate was 2.0%. We conclude that hepatic resection is a safe and satisfactory treatment option for patients with intrahepatic stones.