Laparoscopic Treatment for Hepatolithiasis

Backgrounds and Purposes: The Hepatolithiasis treatment is widely being used for stone removal with the improvement of conservative treat by the development in operations and endoscope. Hepatolithiasis, however, has still a problem which is highly possible in a relapse. Furthermore, it also can be the factor giving rise to cholangitis and cholangiocarcinoma. On this, we have studied that the laparoscopic operation would be the safe and effective remedy for the patients with hepatolithiasis.
Objects and Methods: 22 people, who have hepatolithiasis as well as choledocholithiasis and who had laparoscopic operation in Konyang University Hospital from January 2005 to August 2008, were researched. The operations were performed with choledocoscope, ESWL and Basket to remove choledocholithiasis. By using retrospective method, this research considered the clinical history, ways of surgery, operation period, hospital day, complication and the clearance rate.
Results : The target age range was from 37 to 80 and the average was 58 years old. The spread of men and women was 16 against 8, which had more women(70%). 6 patients had upper abdominal operation scar ( 2 patients with Lt. lateral sectionectomy for liver cholelithiasis, 3 patients with open cholecystectomy, one case with low anterior resection for rectal cancer). 8 cases with Lt. hemihepatectomy were undergone to the patients who had had Lt. hepatolithiasis, 6 cases with Lt. lateral sectionectomy, 2 cases with sectionectomy(Seg 4, 2&4), 4 cases with CBD exploration and stone removal and 9 patients with IHD stone had also common bile duct stone.
There were two open conversions in the case of Rt. Anterior bile duct injury, and post OP adhesion. Each of bile leak and intrabdominal abscess was developed. And there were another case of acute renal failure and two cases of wound infection as a complication, all of these are recovered staying hospital but no further operation or death. After the operation, it was discovered by CT that the rest of IHD stones were remained. This was just one case(0.4%). The average operation time was 415 minutes, the amount of blood loss was 359cc and the hospital days were 11days.
Conclusion : Laparoscopic treatment for hepatolithiasis can be safe and efficacious for the patients with hepatolithiasis and choledocholithiasis. And this method is good for wound recovery, pain and time for recovery. As the trend that, currently, considers the laparoscope treatment as priority, the laparoscopic approach would be the important guide book for curing the patients with hepatolithiasis through the advance of surgical equipment and operation technique.

Session: Poster

Program Number: P415