Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2010; 16(22): 2818-2823
Published online Jun 14, 2010. doi: 10.3748/wjg.v16.i22.2818
Laparoscopic vs open left hepatectomy for hepatolithiasis
Jin-Fu Tu, Fei-Zhao Jiang, Heng-Liang Zhu, Ru-Ying Hu, Wei-Jian Zhang, Zhen-Xu Zhou
Jin-Fu Tu, Fei-Zhao Jiang, Heng-Liang Zhu, Ru-Ying Hu, Wei-Jian Zhang, Zhen-Xu Zhou, Department of Laparoscopic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
Author contributions: Tu JF originated the idea and wrote the paper; Jiang FZ, Tu JF, Zhang WJ and Zhou ZX performed the operation; Zhu HL and Hu RY collected and analyzed the data.
Correspondence to: Dr. Fei-Zhao Jiang, Department of Laparoscopic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China. jfzmdcn@hotmail.com
Telephone: +86-577-88069206 Fax: +86-577-88069555
Received: March 7, 2010
Revised: April 1, 2010
Accepted: April 8, 2010
Published online: June 14, 2010
Abstract

AIM: To explore the feasibility and therapeutic effect of total laparoscopic left hepatectomy (LLH) for hepatolithiasis.

METHODS: From June 2006 to October 2009, 61 consecutive patients with hepatolithiasis who met the inclusion criteria for LLH were treated in our institute. Of the 61 patients with hepatolithiasis, 28 underwent LLH (LLH group) and 33 underwent open left hepatectomy (OLH group). Clinical data including operation time, intraoperative blood loss, postoperative complication rate, postoperative hospital stay time, stone clearance and recurrence rate were retrospectively analyzed and compared between the two groups.

RESULTS: LLH was successfully performed in 28 patients. The operation time of LLH group was longer than that of OLH group (158 ± 43 min vs 132 ± 39 min, P < 0.05) and the hospital stay time of LLH group was shorter than that of OLH group (6.8 ± 2.8 d vs 10.2 ± 3.4 d, P < 0.01). No difference was found in intraoperative blood loss (180 ± 56 mL vs 184 ± 50 mL), postoperative complication rate (14.2% vs 15.2%), and stone residual rate (intermediate rate 17.9% vs 12.1% and final rate 0% vs 0%) between the two groups. No perioperative death occurred in either group. Fifty-seven patients (93.4%) were followed up for 2-40 mo (mean 17 mo), including 27 in LLH group and 30 in OLH group. Stone recurrence occurred in 1 patient of each group.

CONCLUSION: LLH for hepatolithiasis is feasible and safe in selected patients with an equal therapeutic effect to that of traditional open hepatectomy.

Keywords: Hepatolithiasis; Laparoscopy; Hepatectomy; Complication; Therapeutic effect