title: Long-Term Outcomes of Hepatectomy for Bilateral Hepatolithiasis with Three-Dimensional Reconstruction: A Propensity Score Matching Analysis.
abstract: OBJECTIVE
  Bilateral hepatolithiasis tends to show recurrent attacks, which may lead to liver damage and bile duct cancer. This study aimed to assess long-term outcome of hepatectomy for bilateral hepatolithiasis based on three-dimensional reconstruction.
  
  
  METHODS
  A total of 258 bilateral hepatolithiasis patients were enrolled in this retrospective study from January 2008 to October 2014. There are 74 individuals in Three-Divisional Visualization System (MI-3DVS) group (group A) and 74 individuals in non-MI-3DVS group (group B) after propensity score matching (PSM), respectively. Then, complication incidence, stone clearance, recurrence, and recurrence-free survival rates were compared between the two groups. Multivariate Cox analysis was used to test impact of MI-3DVS on recurrence-free survival (RFS).
  
  
  RESULTS
  The Median (Range) volumes of intraoperative blood loss were 300 (30-1050) and 400 (50-1800) mL in group A and B, respectively (P = .037). Meanwhile, immediate clearance (77% versus 53%, P = .002) and final clearance (95% versus 80%, P = .007) rates were higher in group A compared with values obtained for group B. Multivariate Cox analysis showed non-MI-3DVS (HR = 2.00, 95% confidence interval [CI] = 1.02-3.95, P = .045) and patients with bilateral cirrhosis (Hazard Ratio [HR] = 10.60, 95% CI = 4.45-25.25, P < .001) were independent predictors of RFS.
  
  
  CONCLUSIONS
  Compared with conventional radiological technology, MI-3DVS-based hepatectomy resulted in higher stone clearance rate of bilateral hepatolithiasis patients. Non-MI-3DVS and patients with bilateral cirrhosis were independent predictors for recurrence-free survival.
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University , Guangzhou, China .
authors.forename: Tianpei
authors.initials: T
authors.lastname: Guan
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University , Guangzhou, China .
authors.forename: Chihua
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University , Guangzhou, China .
authors.forename: Zhikang
authors.initials: Z
authors.lastname: Mo
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University , Guangzhou, China .
authors.forename: Nan
authors.initials: N
authors.lastname: Xiang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University , Guangzhou, China .
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University , Guangzhou, China .
authors.forename: Ning
authors.initials: N
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D020347:Lithiasis / Q000000981:diagnostic imaging* / Q000601:surgery*; D008107:Liver Diseases / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D057216:Propensity Score; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome