Retrospective Study
Copyright ©The Author(s) 2015.
World J Gastroenterol. Dec 7, 2015; 21(45): 12865-12872
Published online Dec 7, 2015. doi: 10.3748/wjg.v21.i45.12865
Table 1 Patient characteristics n (%)
Patients (n = 202)
Age55 (18-83)
Male:female75:127
Presentation
Acute cholangitis36 (67.3)
Jaundice8 (4.0)
Liver abscess0
Abdominal pain54 (26.7)
Acute pancreatitis4 (2.0)
Previous biliary operation62
Cholecystectomy25 (12.4)
Cholecystectomy plus CBD exploration23 (11.4)
CBD exploration6 (3.0)
Hepatectomy8 (4.0)
Concomitant extrahepatic stones154
GB stones14 (6.9)
CBD stones94 (46.5)
GB + CBD stones46 (22.8)
Stone location
Left58 (28.7)
Right34 (16.8)
Both110 (54.4)
Intrahepatic stricture118 (58.4)
Liver atrophy52 (25.7)
Biliary cirrhosis27 (3.5)
Table 2 Types of operation
Type of operationn (%)
Subcutaneous stoma (n = 202)Gallbladder as a subcutaneous stoma99 (49.0)
Free jejunum as a subcutaneous stoma103 (51.0)
Hepatectomy (n = 97)Left lateral sectionectomy65 (67.0)
Left hepatectomy19 (19.6)
Segmentectomy of segment 65 (5.2)
Segmentectomy of segment 51 (1.0)
Left hepatectomy + right anterior segmentectomy1 (1.0)
Segmentectomy of segment 31 (1.0)
Segmentectomy of segment 5 + segment 61 (1.0)
Segmentectomy of segment 6 + segment 73 (3.1)
Segmentectomy of segment 7 + segment 81 (1.0)
Table 3 Operative short-term outcomes
Short-term outcomePatients (n = 202)Management
Complications21 (10.4)
Biliary leakage9 (4.5)Observation for 8 patients, and reoperation for 1 patient
Wound infection5 (2.5)Dressing
Intra-abdominal bleeding2 (1.0)Observation for 1 patient, and reoperation for 1 patient
Hemobilia2 (1.0)Observation for 1 patient, and reoperation for 1 patient
Low limb thrombosis1 (0.5)Observation
Pleural effusion1 (0.5)Observation
Abdominal fungal infection1 (0.5)Antibiotic
Perioperative mortality0
Immediate stone clearance147 (72.8)
Final stone clearance196 (97.0)
Table 4 Long-term outcomes of surgery
Long-term outcomen (%)
Stone recurrence50 (24.8)
Recurrent attack of acute cholangitis28 (13.9)
Utilization of subcutaneous stoma42 (20.8)
Clearance of recurrent stones42 (84.0)
Development of cholangiocarcinoma5 (2.5)
Death11 (5.4)
Table 5 Risk factors associated with stone recurrence identified with Cox regression model
VariableUnivariate analysis, P valueMultivariate analysis
HR95%CIP value
Age0.572
Gender0.883
Previous biliary surgery0.237
Biliary stenosis0.689
Extrahepatic stones0.417
Stone distribution0.217
Hepatectomy0.191
Types of subcutaneous stoma0.414
Residual stones0.0082.5871.396-4.7950.003