J Korean Surg Soc.  2010 Jan;78(1):35-40. 10.4174/jkss.2010.78.1.35.

The Feasibility of Laparoscopic Hepatectomy for the Patients with Left Intrahepatic Stones

• Song YJ
• Kim KJ
• Moon HG
• Jeong SH
• Ju YT
• Jung EJ
• Lee YJ
• Hong SC
• Choi SK
• Ha WS
• Park ST
• Jeong CY

• KMID: 1775443
• DOI: http://doi.org/10.4174/jkss.2010.78.1.35

Abstract

PURPOSE: Recently, there have been several studies on the early results of hepatectomy for various intrahepatic lesions. We report the early experience of our hospital after total laparoscopic left hepatectomy in patients with intrahepatic stones in the left hemi-liver.
METHODS
We retrospectively analyzed the medical records of patients who were diagnosed with left intrahepatic stones and underwent hepatectomy between January 2007 and June 2009. The patients were grouped according to operative procedure into open hepatectomy, laparoscopy-assisted hepatectomy, and total laparoscopic hepatectomy.
RESULTS
There were 31 patients who underwent Lt hemihepatectomy and Lt lateral sectionectomy during this period. Hepatectomy with open method, laparoscopy-assisted method, and total laparoscopy method were performed in 10, 14, and 7 cases. There were no significant differences between the three methods for operating time and postoperative complications. But the number of fasting times and hospital days was shorter with total laparoscopic hepatectomy than with others.
CONCLUSION
Total laparoscopic liver resection is a safe and useful method for treating patients with intrahepatic stones and offers the advantage of quick patient recovery. Careful selection of appropriate patients and further development in the laparoscopic surgical technique resulting from accumulated experiences will help enable the laparoscopic hepatectomy to be performed more easily and safely in patients with intrahepatic stones.

Keyword

Intrahepatic stone; Laparoscopic hepatectomy; Laparoscopy-assisted hepatectomy

MeSH Terms

Fasting
Hepatectomy
Humans
Imidazoles
Laparoscopy
Liver
Medical Records
Nitro Compounds
Postoperative Complications
Retrospective Studies
Surgical Procedures, Operative
Imidazoles
Nitro Compounds

Figure

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  Fig. 1 Port site. (1) 10 mm camera; (2) 10 mm assist right hand; (3) 5 mm surgeon left hand; (4) 12 mm surgeon right hand; (5) 5 mm assist left hand.

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  Fig. 2 Division of left portal vein.

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  Fig. 3 After liver resection, using the suction device and catheter, remnant bile duct stone removed as many as possible, and then choledocoscopy was inserted to resected bile duct.

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  Fig. 4 Postoperative abdominal wound. The extension of incision is showing below the umbilicus.

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