Contrast of therapeutic effects between CBD incision and LLHD stump in biliary tract exploration of LLS for hepatolithiasis
- 47 Downloads
Laparoscopic left lateral sectionectomy (LLS) followed by a biliary tract exploration is used to treat left lateral hepatolithiasis. The purpose of this study was to compare the efficacy of two methods of biliary tract explorations in LLSs: biliary tract exploration through a common bile duct (CBD) incision or through the left lateral hepatic duct (LLHD) stump.
One hundred eight patients were retrospectively analyzed in our hospital from 2009 to 2018. To compare different methods of biliary tract explorations during LLSs, the patients were divided into 2 groups: 36 patients underwent biliary tract exploration through the LLHD stump (LLSS group), and 72 patients underwent biliary tract exploration through the CBD incision (LLSC group). Clinical data on disease characteristics, surgical outcomes, and surgery-related complications were compared between the 2 groups.
Bile duct stones were successfully cleared in all patients. For 2 patients in the LLSS group and 3 patients in the LLSC group, treatment was switched to laparotomy. There were no significant differences in the total operation time (P = 0.09), incidence of bleeding volume (P = 0.33), and bile leakage (P = 0.12) between the two groups. The time of choledochoscopy in the LLSS group was significantly lower than that in the LLSC group (P = 0.03). No bile duct injuries, strictures, recurrent stones, or other adverse events were observed in any patients during follow-up.
Exploration of the biliary tract through the LLHD stump is safe and provides satisfactory results for select patients.
KeywordsHepatolithiasis Laparoscopic left lateral hepatic sectionectomy Lithotripsy
This work was undertaken in partial fulfillment for Guangdong Provincial People’s Hospital.
Compliance with ethical standards
Huiling Wang, Yingliang Ou, Jinrui Ou, and Zhuixiang Jian have no conflicts of interest or financial ties to disclose.
- 11.Sun WB, Han BL, Cai JX (2000) The surgical treatment of isolated left-sided hepatolithiasis: a 22-year experience. Sugery 127(5):493–497Google Scholar