title: Laparoscopic approach for right-sided intrahepatic duct stones: a comparative study of laparoscopic versus open treatment.
abstract: BACKGROUND
  Despite several attempts to treat intrahepatic duct (IHD) stones by laparoscopy, most cases have been limited to left-sided IHD stones. The aim of this study was to evaluate the therapeutic feasibility and effectiveness of a laparoscopic approach for right-sided IHD stones compared with the open approach for this disease.
  
  
  METHODS
  This study included 34 consecutive patients who underwent laparoscopic (n = 17) and open (n = 17) treatment for right-sided IHD stones from March 2005 to December 2011. Clinical data including the operative time, intraoperative blood loss, postoperative hospital length of stay, postoperative complications, stone clearance, and recurrence rate were retrospectively analyzed and compared between the two groups.
  
  
  RESULTS
  Of the 17 patients who underwent laparoscopic treatment, three were treated using laparoscopic intrahepatic duct exploration alone and 14 patients were treated using laparoscopic liver resection. The operative time in the laparoscopic group was longer than that in the open group (432 ± 158 vs. 335 ± 85 min, p = 0.03). The laparoscopic group showed a lower postoperative complication rate than the open group (29 vs. 64 %, p = 0.039). There were no significant differences in intraoperative blood loss (988 ± 929 vs. 879 ± 942 ml, p = 0.737) or postoperative length of hospital stay (16 ± 22 vs. 12 ± 14 days, p = 0.221).
  
  
  CONCLUSIONS
  This study demonstrated that laparoscopic treatment could be an effective and safe therapeutic modality in selected patients with right-sided IHD stones.
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea, gsurgeon80@gmail.com.
authors.forename: Young Ki
authors.initials: YK
authors.lastname: Kim
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Woohyung
authors.initials: W
authors.lastname: Lee
mesh_terms: D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D016063:Blood Loss, Surgical; D005260:Female; D042882:Gallstones / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome