Development and validation of a postoperative prediction model for residual stones after hepatectomy in patients with hepatolithiasis

doi:10.4240/wjgs.123786

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Nov 27, 2026; 18(11): 123786
Published online Nov 27, 2026. doi: 10.4240/wjgs.123786

Table 2 Clinically relevant characteristics according to residual-stone status, n (%)/median (interquartile range)

Item	Overall (n = 300)	Non-residual stone group (n = 218)	Residual stone group (n = 82)	P value
Baseline characteristics
Age (years)	58.00 (51.00-66.00)	58.00 (52.00-66.00)	56.50 (50.00-65.00)	0.401
Sex				0.428
Male	101 (33.67)	70 (32.11)	31 (37.80)
Female	199 (66.33)	148 (67.89)	51 (62.20)
BMI	22.04 (19.94-24.22)	22.22 (19.98-24.41)	21.34 (19.55-23.56)	0.195
Symptoms
Abdominal pain	229 (76.33)	161 (73.85)	68 (82.93)	0.135
Nausea and vomiting	71 (23.67)	46 (21.10)	25 (30.49)	0.121
Fever	72 (24.00)	46 (21.10)	26 (31.71)	0.078
Jaundice	27 (9.00)	19 (8.72)	8 (9.76)	0.957
HBV infection	34 (11.33)	23 (10.55)	11 (13.41)	0.622
Diabetes	43 (14.33)	24 (11.01)	19 (23.17)	0.013
Hypertension	49 (16.33)	39 (17.89)	10 (12.20)	0.311
Previous surgical history
Cholecystectomy	114 (38.00)	77 (35.32)	37 (45.12)	0.154
Choledochoscopy	64 (21.33)	45 (20.64)	19 (23.17)	0.750
Cholangioenterostomy	19 (6.33)	14 (6.42)	5 (6.10)	1.000
Partial hepatectomy	14 (4.67)	8 (3.67)	6 (7.32)	0.304
Stone classification¹				0.289
Type I	34 (11.33)	28 (12.84)	6 (7.32)
Type IIa	54 (18.00)	39 (17.89)	15 (18.29)
Type IIb	48 (16.00)	39 (17.89)	9 (10.98)
Type IIc	10 (3.33)	7 (3.21)	3 (3.66)
Type E	154 (51.33)	105 (48.17)	49 (59.76)
Disease duration (months)	1.50 (0.50-12.00)	1.50 (0.50-12.00)	1.50 (0.50-21.00)	0.625
Imaging
Gallstones	77 (25.67)	58 (26.61)	19 (23.17)	0.646
Cholangitis	117 (39.00)	79 (36.24)	38 (46.34)	0.143
Liver abscess	44 (14.67)	27 (12.39)	17 (20.73)	0.101
Liver atrophy	104 (34.67)	74 (33.94)	30 (36.59)	0.770
Liver cirrhosis	23 (7.67)	12 (5.50)	11 (13.41)	0.040
Biliary stricture	79 (26.33)	33 (23.24)	46 (29.11)	0.307
Biliary dilation	282 (94.00)	205 (94.04)	77 (93.90)	1.000
Stone location				< 0.001
Unilateral	225 (75.00)	183 (83.94)	42 (51.22)
Bilateral	75 (25.00)	35 (16.06)	40 (48.78)
Intraoperative characteristics
Surgical method				0.486
OH	142 (47.33)	100 (45.87)	42 (51.22)
LH	158 (52.67)	118 (54.13)	40 (48.78)
Operative time (minutes)	295.00 (230.75-335.00)	280.00 (219.25-322.75)	335.00 (305.50-404.00)	< 0.001
Intraoperative blood loss (mL)	300.00 (200.00-500.00)	300.00 (200.00-500.00)	400.00 (200.00-600.00)	0.009
Intraoperative blood transfusion	26 (8.67)	17 (7.80)	9 (10.98)	0.521
ASA classification				0.505
I	205 (68.33)	146 (66.97)	59 (71.95)
II	93 (31.00)	71 (32.57)	22 (26.83)
III	2 (0.67)	1 (0.46)	1 (1.22)
Number of pringle maneuvers				0.220
≤ 3	215 (71.67)	161 (73.85)	54 (65.85)
> 3	85 (28.33)	57 (26.15)	28 (34.15)
Liver resection extent				0.202
Left	158 (52.67)	118 (54.13)	40 (48.78)
Left lateral	71 (23.67)	55 (25.23)	16 (19.51)
Right	34 (11.33)	20 (9.17)	14 (17.07)
Right posterior	15 (5.00)	8 (3.67)	7 (8.54)
Left medial lobe + right anterior	5 (1.67)	4 (1.83)	1 (1.22)
Right anterior	3 (1.00)	3 (1.38)	0 (0.00)
Others²	14 (4.67)	10 (4.59)	4 (4.88)
Other related procedures
Cholecystectomy	136 (45.33)	97 (44.50)	39 (47.56)	0.730
Choledochoenterostomy	90 (30.00)	61 (27.98)	29 (35.37)	0.270
T-tube drainage	210 (70.00)	168 (77.06)	42 (51.22)	< 0.001
Postoperative complications
Anastomotic stenosis	30 (10.00)	16 (7.34)	14 (17.07)	0.022
Postoperative biliary stricture	56 (18.67)	20 (9.17)	36 (43.90)	< 0.001
Abdominal infection	23 (7.67)	17 (7.80)	6 (7.32)	1.000
Pulmonary infection	93 (31.00)	71 (32.57)	22 (26.83)	0.413
Incision infection	12 (4.00)	7 (3.21)	5 (6.10)	0.420
Abdominal hemorrhage	8 (2.67)	5 (2.29)	3 (3.66)	0.801
Intestinal obstruction	6 (2.00)	3 (1.38)	3 (3.66)	0.426
Positive pathogen culture
Bile	57 (19.00)	32 (14.68)	25 (30.49)	0.003
Peritoneal drainage fluid	27 (9.00)	14 (6.42)	13 (15.85)	0.020
Blood	32 (10.67)	21 (9.63)	11 (13.41)	0.462
Bile leakage	38 (12.67)	16 (7.34)	22 (26.83)	< 0.001
Intestinal leakage	11 (3.67)	4 (1.83)	7 (8.54)	0.016

¹Stone classification was based on Dong’s classification.

²Others indicate single-segment resections grouped because of small sample sizes.

BMI: Body mass index; HBV: Hepatitis B virus; OH: Open hepatectomy; LH: Laparoscopic hepatectomy; ASA: American Society of Anesthesiologists.

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Citation: Shao HR, Zeng D, Chen X, Zhu Y, Liu LX, Zhao SL, Zou H. Development and validation of a postoperative prediction model for residual stones after hepatectomy in patients with hepatolithiasis. World J Gastrointest Surg 2026; 18(11): 123786
URL: https://www.wjgnet.com/1948-9366/full/v18/i11/123786.htm
DOI: https://dx.doi.org/10.4240/wjgs.123786

Shao HR, Zeng D, Chen X, Zhu Y, Liu LX, Zhao SL, Zou H. Development and validation of a postoperative prediction model for residual stones after hepatectomy in patients with hepatolithiasis. World J Gastrointest Surg 2026; 18(11): 123786 [DOI: 10.4240/wjgs.123786]

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