The Resultof Hepatic Resection for Intrhepatic Duct Stone

Lee, Tae Young; Kim, Hae Young; Sim, Mun Sup; Moon, Sang Eun

Abstract

BACKGROUND/AIMS: Intrahepatic duct stone (IHDS) present serious health problem because the incidence of recurrent or residual stones are high and the stones induce hepatic damage. Moreover its prevalence is higher in east Asian than in any others. Hepatic resection is known as the mos definitive procedure especially for patients with ductal stricture, but postoperative morbidity and the incidence of residual or recurrent stones are still high.
METHODS
We analyzed early and late complication according to the type of hepatic resection in IHDS (44 cases) and determined the predisposing factors related to complications.
RESULTS
Location of IHDS was left in 34 cases (77.2%), right in 1 case (2.3%), and both in 9 cases (20.5%). Thirty one cases (70.5%) had conco mitant extrahepatic duct stone. The type of hepatic resection was left lateral segmentectomy in 23 cases (52.2%), left lobectomy in 18 cases (40.9%) and right lobectomy in 3 cases (6.9%). The overal early complication rate was 54.5% and was increased according to the extent of resection (p<0.05) The overall incidence of residual or recurrent stone was 31.8% and it was high in patients with lef lateral segmentectomy and without biliary drainage procedure, but it was not statistically significant The postoperative mortality was 6.8% (3 cases).
CONCLUSIONS
Hepatic resection can be a curative therapy in IHDS and routine use of intraoperative choledochoscopy is recommended to minimize the incidence of residual stone.