Viral Hepatitis
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 21, 2006; 12(3): 431-436
Published online Jan 21, 2006. doi: 10.3748/wjg.v12.i3.431
Favorable outcomes of hilar duct oriented hepatic resection for high grade Tsunoda type hepatolithiasis
Bong-Wan Kim, Hee-Jung Wang, Wook-Hwan Kim, Myung-Wook Kim
Bong-Wan Kim, Hee-Jung Wang, Wook-Hwan Kim, Myung-Wook Kim, Department of Surgery, Ajou University School of Medicine, Wonchon dong, Youngtong ku, Suwon, Kyounggi Province, South Korea
Correspondence to: Professor Hee-Jung Wang, MD, PhD, Department of Surgery, Ajou University School of Medicine, San-5, Wonchon dong 442-749, Youngtong ku, Suwon, South Korea. wanghj@ajou.ac.kr
Telephone: +82-31-219-5204 Fax: +82-31-219-5755
Received: June 29, 2005
Revised: June 29, 2005
Accepted: July 28, 2005
Published online: January 21, 2006
Abstract

AIM: To evaluate the efficacy of hilar duct oriented hepatectomy for intractable hepatolithiasis, the ventral hilum exposure (VHE) method that has been applied by the authors.

METHODS: From June 1994 to June 2004 for a period of 10 years, 153 patients who had Tsunoda type III or IV hepatolithiasis, received hepatectomy at our institution. Among these patients, 128 who underwent hepatectomy by the VHE method were the subjects for the study. We analyzed the risk of this procedure, residual rate of intra-hepatic stones, and stone recurrent rates.

RESULTS: The average age was 54.2 years, and the male to female ratio was 1:1.7. The average follow-up period was 25.6 mo (6-114 mo). There was no post-operative severe complication or mortality after the operation. The rate of residual stones was 5.4% and the rate of recurrent stones was 4.2%.

CONCLUSION: VHE is a safe surgical procedure and provides favorable treatment results of intractable hepatolithiasis. Especially, this procedure has advantage in that intra-hepatic bile duct stricture may be confirmed and corrected directly during surgery.

Keywords: Hepatolithiasis, Hepatic resection, Residual stone, Recurrent stone