Initial Experience of Laparoscopic Hepatectomy for Intrahepatic Duct (IHD) Stones: Comparison with Open Hepatectomy

Lee, Joon Sang; Choi, Yoo Shin; Lee, Seung Eun

Abstract

PURPOSE
The aim of this study is to analyze our initial experiences with laparoscopic hepatectomy for treatment of intrahepatic duct (IHD) stones and to compare the outcomes of laparoscopic hepatectomy and open hepatectomy.
METHODS
From March 2010 to December 2012, for treatment of IHD stones we performed laparoscopic hepatectomy in seven cases (LH group), which consisted of four cases of left lateral sectionectomy and three cases of left hepatectomy, and open hepatectomy was performed in nine cases (OH group), which consisted of seven cases of left lateral sectionectomy and two cases of left hepatectomy. Because there was no case of right hepatectomy in the LH group, we excluded a case of right hepatectomy in the OH group. Retrospective analysis of the clinical outcomes was performed with exclusion of one case of right hepatectomy.
RESULTS
There was no significant difference in male to female ratio, mean age, and mean operation time. The mean postoperative hospital stay of the LH group was significantly shorter than that of the OH group (10.9+/-4.7 vs. 22.0+/-9.0 days, p=0.007). There were two cases of intra-abdominal fluid collection in the OH group, but no case in the LH group. Remnant stones were detected in one patient of the LH group and two patients of the OH group. The initial success rate of stone clearance was 85.7% in the LH group and 77.8% in the OH group. During a mean follow-up period of 13 months (range, four to 25 months), recurrent stone was detected in one case of the OH group.
CONCLUSION
Laparoscopic surgery could be an effective treatment modality for management of IHD stones in select patients.