Favorable outcomes of hilar duct oriented hepatic resection for high grade Tsunoda type hepatolithiasis.
OBJECTIVE
To evaluate the efficacy of hilar duct oriented hepatectomy for intractable hepatolithiasis, the ventral hilum exposure (VHE) method that has been applied by the authors.


METHODS
From June 1994 to June 2004 for a period of 10 years, 153 patients who had Tsunoda type III or IV hepatolithiasis, received hepatectomy at our institution. Among these patients, 128 who underwent hepatectomy by the VHE method were the subjects for the study. We analyzed the risk of this procedure, residual rate of intra-hepatic stones, and stone recurrent rates.


RESULTS
The average age was 54.2 years, and the male to female ratio was 1:1.7. The average follow-up period was 25.6 mo (6-114 mo). There was no post-operative severe complication or mortality after the operation. The rate of residual stones was 5.4% and the rate of recurrent stones was 4.2%.


CONCLUSIONS
VHE is a safe surgical procedure and provides favorable treatment results of intractable hepatolithiasis. Especially, this procedure has advantage in that intra-hepatic bile duct stricture may be confirmed and corrected directly during surgery.
Department of Surgery, Ajou University School of Medicine, San-5, Wonchon dong 442-749, Youngtong ku, Suwon, South Korea.
Bong-Wan
BW
Kim
Hee-Jung
HJ
Wang
Wook-Hwan
WH
Kim
Myung-Wook
MW
Kim
D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D020347:Lithiasis / Q000473:pathology / Q000601:surgery*; D008107:Liver Diseases / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome