Liver resection for hepatolithiasis: A multicenter experience in Latin America

García, Daniel; Marino, Carlo; Coelho, Fabrício Ferreira; Rebolledo, P.; Achurra, Pablo; Fonseca, Gilton Marques; Krüger, Jaime; Viñuela, Eduardo; Briceño, Eduardo; D’Albuquerque, Luiz Carneiro; Jarufe, Nicolás; Martínez, Jorge; Herman, Paulo; Dib, M.

doi:10.1016/j.surg.2022.10.024

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Regardless of whether liver cancer is at an early or advanced stage, LR is regarded as the most effective treatment strategy. Hepatolithiasis is a prevalent disease in Asia, and LR is an effective and de nitive treatment for patients with hepatolithiasis [2]. Above all, LR is a common surgery in clinical anesthesia work in China.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac Arrest During Liver Resection: two cases report

Shang,

Wang,

Weng

et al. 2024

Preprint

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Background Patients with liver diseases often require surgery, and liver resection is a common surgical procedure. Intermittent Pringle Maneuver (IPM) is always used to control blood loss during liver resection surgery, but ischemia-reperfusion injury reduced by IPM will lead rapid change of internal environment, which will increase patients’ perioperative risk. Case presentation We reported a 59-year-old male and a 44-year-old male who underwent liver resection surgery for liver cancer and hepatolithiasis respectively. Cardiac arrest occurred during the procedure. Luckily, with high quality of cardiopulmonary resuscitation and electrical defibrillation, acidosis correction, as well as the treatment of lowering K+ and increasing Ca2+, they were rescued. The two patients recovered well without complication in 1-month followed-up. Conclusion In liver resection, the anesthesiologists need to pay close attention to the electrocardiography changes, especially at the moment of vascular opening during IPM. In addition, how to ensure the stability of patients’ internal environment during liver resection is an important clinical research work, which will provide evidence-based medical reference for anesthesiologists.

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Section: Discussionmentioning

confidence: 99%

“…Liver resection (LR) is one of the primary treatment strategies for all kinds of liver diseases, such as liver tumors [1], hepatolithiasis [2], and so on. Intermittent Pringle maneuver (IPM) is a common strategy to control of bleeding [3].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Arrest During Liver Resection: two cases report

Shang,

Wang,

Weng

et al. 2024

Preprint

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“…Over a long period of time, hepatolithiasis can lead to liver fibrosis, liver atrophy, liver abscess, secondary cirrhosis, and even cholangiocarcinoma 3 , 4 , which seriously threatens the health and quality of life of patients. In this case, hepatectomy is the most effective and definitive method, which can simultaneously remove the stones and accompanying liver lesions 1 , 3 , 5 .…”

Section: Introductionmentioning

confidence: 99%

Clinical and economic comparison of laparoscopic versus open hepatectomy for primary hepatolithiasis: a propensity score-matched cohort study

Chen,

Zhang,

Cheng

et al. 2024

International Journal of Surgery

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Background: It is unclear whether laparoscopic hepatectomy (LH) for hepatolithiasis confers better clinical benefit and lower hospital costs than open hepatectomy (OH). This study aim to evaluate the clinical and economic value of LH versus OH. Methods: Patients undergoing OH or LH for primary hepatolithiasis at Yijishan Hospital of Wannan Medical College between 2015 and 2022 were divided into OH group and LH group. Propensity score matching (PSM) was used to balance the baseline data. Deviation-based cost modelling and weighted average median cost (WAMC) were used to assess and compare the economic value. Results: A total of 853 patients were identified. After exclusions, 403 patients with primary hepatolithiasis underwent anatomical hepatectomy (OH n=143; LH n=260). PSM resulted in 2 groups of 100 patients each. Although LH required a longer median operation duration compared with OH (285.0 versus 240.0 min, respectively, P<0.001), LH patients had fewer wound infections, fewer pre-discharge overall complications (26 versus 43%, respectively, P=0.009), and shorter median postoperative hospital stays (8.0 versus 12.0 days, respectively, P<0.001). No differences were found in blood loss, major complications, stone clearance, and mortality between the two matched groups. However, the median overall hospital cost of LH was significantly higher than that of OH (CNY¥52,196.1 versus 45,349.5, respectively, P=0.007). Although LH patients had shorter median postoperative hospital stays and fewer complications than OH patients, the WAMC was still higher for the LH group than for the OH group with an increase of CNY¥9,755.2 per patient undergoing LH. Conclusion: The overall clinical benefit of LH for hepatolithiasis is comparable or even superior to that of OH, but with an economic disadvantage. There is a need to effectively reduce the hospital costs of LH and the gap between costs and diagnosis-related group reimbursement to promote its adoption.

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Section: Introductionmentioning

confidence: 99%

“…A recurrence rate of 29.6% and a mortality rate of 10.6% were evidenced [2,3]. In the Latin American experience, the 30-day mortality is around 0.7%, and the morbidity is 30% after surgery [4]. Thus, minimally invasive therapeutics for treating IHL are on the rise, such as biliary tract exploration via the left hepatic duct, percutaneous transhepatic drainage, per-oral cholangioscopy, and cholangioscopy associated with laparoscopic and robotic procedures [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Complex Intrahepatic Lithiasis: A Case Report of Combined Treatment With Surgical Exploration of the Bilioenteric Anastomosis and Laser Lithotripsy by Cholangioscopy

Lera dos Santos,

Sasso,

Figueira

et al. 2023

Cureus

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Intrahepatic lithiasis, or hepatolithiasis, is an endemic disease in southeast Asia, although, with immigration from Eastern countries, the incidence of this pathology is rising worldwide. The Latin American experience demonstrates morbidity and mortality compatible with other Western countries, but minimally invasive procedures are lacking. We demonstrate a case of a combined surgical and endoscopic approach for stone clearance. We present a case of a 47-year-old female patient with biliary enteric anastomosis to treat recurrent pyogenic cholangitis resulting from intrahepatic lithiasis. The patient was admitted to the emergency room, presented with a new episode of cholangitis, and submitted to transcutaneous hepatobiliary drainage. The multidisciplinary approach, including the endoscopic and surgical teams, successfully performed the stone clearance with laser lithotripsy and stone removal by open access. The postoperative period was uneventful, and the patient did not present any sign of recurrence after one year. A combined surgical and endoscopic approach achieved short-term clinical and technical success in this novel case. Moreover, individualizing cases requiring open surgical access is feasible, which allows a combined endoscopic approach with safety.

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Liver resection for hepatolithiasis: A multicenter experience in Latin America

Cited by 7 publications

References 30 publications

Cardiac Arrest During Liver Resection: two cases report

Cardiac Arrest During Liver Resection: two cases report

Clinical and economic comparison of laparoscopic versus open hepatectomy for primary hepatolithiasis: a propensity score-matched cohort study

Complex Intrahepatic Lithiasis: A Case Report of Combined Treatment With Surgical Exploration of the Bilioenteric Anastomosis and Laser Lithotripsy by Cholangioscopy

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