Long-term results of hepaticojejunostomy for hepatolithiasis.
The results of a hepaticojejunostomy as a biliary-enteric bypass for benign disease are usually excellent. On the other hand, hepatolithiasis features a high rate of residual and recurrent stones with cholangitis after surgery. This study aims to evaluate the long-term results of a hepaticojejunostomy for hepatolithiasis regarding both the degree of the occurrence of postoperative cholangitis and the outcome. The clinical records of 159 patients with hepatolithiasis who underwent surgical treatment over a 23-year period were also retrospectively reviewed. Ninety-four of 159 patients underwent a hepatecetomy and 65 patients were subjected to liver-preserving surgery by means of intra- and postoperative endoscopic lithotripsy. In addition 72 patients underwent a hepaticojejunostomy. The rate of residual or recurrent stones was 31.4 per cent after complete stone removal. Twenty-two (30.6%) of the 72 patients developed some kind of cholangitis. This rate was significantly higher than that (three of 87 patients) of the non-biliary-enteric anastomosis group regarding the occurrence of biliary complications. We conclude that the use of a hepaticojejunostomy for patients with possible residual stones or intrahepatic bile duct lesions remains controversial.
Kusano
T
T
First Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Isa
T T
TT
Muto
Y
Y
Otsubo
M
M
Yasaka
T
T
Furukawa
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002137:Calculi / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007582:Jejunostomy; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors