Korean J Hepatobiliary Pancreat Surg.  2001 Dec;5(2):55-63.

The Surgical Investigation of Hepatic Resection for Intrahepatic Duct Stone

• Jung YJ
• Kim DH
• Sim MS

Abstract

BACKGROUND/AIMS: Intrahepatic duct stone (IHDS) present serious health problem in East Asian countries including Korea because of recurrent or residual stones and stones induced hepatic damage. Hepatic resection is known as most definitive procedure especially in patients with ductal stricture, but postoperative morbidity and residual or recurrent stones are still high.
METHODS
We analyzed early and late complication according to type of hepatic resection in IHDs (38 cases) and also determined the predisposing factors related to complication.
RESULTS
Location of IHDs was left in 30 cases (78.9%), right in 1 case (2.7%), both in 7 cases (18.4%), and 28 cases (73.7%) had concomitant extrahepatic duct stone. The type of hepatic resection was left lateral segmentectomy in 24 cases (63.2%), left lobectomy in 11 cases (28.9%) and right lobectomy in 3 cases (7.9%). Overall complication rate was 44.7% and it was increased by extension of resection (p<0.05). Overall incidence of residual or recurrent stone was 36.8% and it was higher in patients with left lateral segmentectomy and without biliary drainage procedure although statistically not significant. The postoperative mortality was 11.8% (2 cases).
CONCLUSIONS
Hepatic resection can be a curative therapy in IHDS and routine use of intraoperative choledochoscopy and additional drainage procedures are recommended to minimize the incidence of residual or recurrent stones.

Keyword

Intrahepatic duct stone; Hepatic resection

MeSH Terms

Asian Continental Ancestry Group
Causality
Constriction, Pathologic
Drainage
Humans
Incidence
Korea
Mastectomy, Segmental
Mortality