[The timing of hepatectomy for hepatolithiasis complicated with acute cholangitis].
OBJECTIVE
To evaluate the optimal timing of hepatectomy for intrahepatic lithiasis complicated with acute cholangitis.


METHODS
One hundred and twenty-six patients with hepatolithiasis who had a history of acute cholangitis and underwent hepatectomy were reviewed retrospectively. According to the period between the surgery and last attack of acute cholangitis, 126 patients were divided into 3 groups: > 3 months (group A, n = 73), 1 approximately 3 months (group B, n = 28), < 1 month (group C, n = 25). The operation time, blood loss, hospital stay, postoperative complications and stone residual rate were compared among the groups.


RESULTS
The intraoperative blood loss of C group was (644.0 +/- 625.7) ml, which was significantly higher than those of A and B group [(409.2 +/- 250.7) ml and (423.2 +/- 237.1) ml, respectively]. The numbers of patients who needed transfusion and the amount of blood transfusion in group C were also higher than those of group A and B. The incidence rate of complications, residual stone in group C were all markedly higher than those of group A and B. The period of hospital stay in group C was much longer than that in group A and B.


CONCLUSIONS
The optimal timing of hepatectomy for hepatolithiasis complicated with acute cholangitis is at least one month after subsidence of cholangitis.
Li
Shao-qiang
SQ
Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Liang
Li-jian
LJ
Peng
Bao-gang
BG
Li
Dong-ming
DM
Lü
Ming-de
MD
D000328:Adult; D000368:Aged; D001653:Bile Ducts, Intrahepatic; D002761:Cholangitis / Q000150:complications*; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors