Totally laparoscopic left hemihepatectomy using ventral hilum exposure (VHE) for intrahepatic bile duct stone.
The unique technique of ventral hilum exposure (VHE) was reported that it had excellent surgical outcomes in patients with intrahepatic bile duct stone. The basis of this surgical technique is that all the openings of the 2nd-order bile duct branches are exposed fully. In this article, we describe laparoscopic hemihepatectomy from using the VHE method in a patient with intrahepatic bile duct stone. Our patient was a 70-year-old female who had been diagnosed with an intrahepatic duct stone 30 years prior. Multiple intrahepatic bile duct stones in the left lateral section of the liver were revealed by abdominal computed tomography and magnetic resonance cholangiopancreatography. The patient resumed her oral intake on postoperative day 6. The patient had hyperbilirubinemia (10.3 mg/100 mL) on postoperative day 10. However, her serum bilirubin level decreased to 2.7 mg/100 mL on postoperative day 28. She was discharged without any serious complications on postoperative day 31. Totally laparoscopic left hemihepatectomy, using the VHE method, can be one option of surgical procedure in the near future, although a larger series of cases should be necessary to prove the feasibility of laparoscopic VHE.
Kim
In-Gyu
IG
Department of Surgery, Hallym University College of Medicine, Anyang, Korea. kig2001@hallym.or.kr
Jeon
Jang-Yong
JY
Jung
Jae-Pil
JP
Chon
Seong-Eun
SE
Kim
Han-Jun
HJ
Kim
Doo-Jin
DJ
Kim
Joo-Seop
JS
D000368:Aged; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed