Intraoperative biliary exploration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis

Hwang, Shin; Lee, Sung‐Gyu; Kim, Myung–Hwan; Lee, Sung‐Koo; Ahn, Chul‐Soo; Kim, Ki‐Hun; Lee, Young‐Joo

doi:10.1007/s00423-007-0200-7

Cited by 20 publications

(15 citation statements)

References 25 publications

(42 reference statements)

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“…The treatment of patients with bilateral hepatolithiasis is controversial and patients with bilateral disease show higher rates of recurrence. Therapeutic approaches range from hepatectomy to complex bilioenteric anastomosis using a subcutaneous loop to remove residual or recurrent lithiasis 41–43 . In the present series, only four patients had bilateral hepatolithiasis, three of whom underwent hepatectomy for severe involvement in segments on both sides.…”

Section: Discussionmentioning

confidence: 70%

Anatomic hepatectomy as a definitive treatment for hepatolithiasis: a cohort study

Jarufe

Figueroa

Muñoz

et al. 2012

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Section: Discussionmentioning

confidence: 70%

Anatomic hepatectomy as a definitive treatment for hepatolithiasis: a cohort study

Jarufe

Figueroa

Muñoz

et al. 2012

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“…In the present study left hepatectomy was the commonest resection modality employed, which is in concordance with some recent studies. [21][22][23] Hwang et al 22 has recommended left hepatectomy instead of left lateral segmentectomy, because ductal strictures are usually near the confluence of the right and left ducts. After hepatectomy, the right and common ducts are explored for intraductal stones through the left hepatic duct orifice.…”

Section: Discussionmentioning

confidence: 99%

Outcome of surgery for recurrent pyogenic cholangitis: a single center experience

Ray

Sanyal

Das

et al. 2016

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“…Cholecystectomy and/or hepatectomy followed by CBDE is required for the patient suffering choledocholithiasis with complicating cholecystitis and/or intrahepatic gallstones [11,12]. The left intrahepatic stones consist of the majority of intrahepatic gallstones [13], which usually receive left hepatectomy after longterm repeated cholangitis.…”

Section: Discussionmentioning

confidence: 99%

Three modalities on common bile duct exploration

et al. 2017

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Choledocholithiasis can be managed by transcystic (TC) and transduct (TD) stone extraction or using cholangioscopy through the left hepatic duct orifice (LHD). The aim of this study is to evaluate the safety and effectiveness of common bile duct exploration through the TC approach, TD approach, and LHD approach for choledocholithiasis, with a specific emphasis on the TC and LHD approaches versus the TD approach. Between January 2011 and June 2014, a total of 172 choledocholithiasis patients accompanied by cholecystitis and/or left intrahepatic gallstones were scheduled for laparoscopic or open common bile duct (CBD) exploration using cholangioscopy through the CBD (TD group: n = 72), cystic duct (TC group: n = 63), or LHD orifice (LHD group: n = 37). T-tube insertion was performed in selected patients. Patients were regularly followed up at bimonthly intervals or more frequently in presence of any symptom. Primary outcomes measures included overall operative time, length of hospital stay, and postoperative bile leaks. Successful bile duct clearance was 100 % in the TD group, 93.6 % in the TC group, and 90.9 % in the LHD group. Sixteen cases in the TD group had T-tube placement in contrast to no cases in the TC and LHD groups. There were more bile leaks after TD stone extraction (12.5 %) than TC (3.2 %) and LHD stone extraction (0 %), which prolonged hospitalization in the TD group more than in the TC and LHD groups. For choledocholithiasis patients accompanied by cholecystitis, 2 groups (TC and TD groups) were comparable in operative time. However, for choledocholithiasis patients accompanied by left intrahepatic gallstones, the LHD group had a significantly shorter operative time than the TD group (121.1 ± 16.9 minutes vs. 149.3 ± 42.8 minutes, p< 0.05). The TD group had a higher stone clearance rate but was associated with a higher risk of bile leaks. TC and LHD stone extraction, which seems to be the more effective approach with lower complication rates, is an accessible technique that simplifies the operation procedure by avoiding choledochotomy and subsequent T-tube insertion.

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Intraoperative biliary exploration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis

Abstract: We think that intraoperative biliary exploration through LHD orifice in left-sided hepatolithiasis patients is an effective approach simplifying the operation procedure by avoiding choledochotomy and subsequent T-tube insertion.

Cited by 20 publications

References 25 publications

Anatomic hepatectomy as a definitive treatment for hepatolithiasis: a cohort study

Anatomic hepatectomy as a definitive treatment for hepatolithiasis: a cohort study

Outcome of surgery for recurrent pyogenic cholangitis: a single center experience

Three modalities on common bile duct exploration

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