关键词: 肝内胆管结石, 肝切除术, 手术时机

Abstract: 【Abstract】〓Objective〓To investigate the selection of the timing and methods of surgery for intrahepatic bile duct stones. Methods〓Between January 1995 and December 2014, 78 patients with left-sided hepatolithiasis were analyzed retrospectively in our hospital. This study focused on the choice of surgical methods and sugical opportunity, the complications, and long-term outcomes. Results〓Among the surgical modality, the hepatectomy was used for left-sided hepatolithiasis more generally this decade, compared with 10 years ago (87.0% vs 21.9%, P=0.009), in particular the regular left hepatectomy (54.3% vs 0.0%,(P<0.001)..The postoperative stone residual rate of hepatectomy group was significantly less than non-hepatectomy operations (67.7% vs 12.8%, P=0.013). Furthermore, the stone residual rate of regular left hepatectomy was remarkably lower than left lateral segmentectomy(22.2% vs 4.0%,P=0.026). In addition, emergency hepatectomy induced significantly more operative time,more volume of blood loss, more length of postoperative hospital stay, higher frequency of procedure-related complications, and higher postoperative stone residual rate(17.4% vs 8.3%,P=0.043),compared with selective hepatectomy. Conclusion〓As the safe and effective technique in our primary hospital, the outcome of hepatectomy for left-sided hepatolithiasis is markedly superior to non-hepatectomy operations.Moreover,regular left hepatectomy is better than left lateral segmentectomy. It is notable that emergency hepatectomy is very dangerous and has poor outcomes. So emergency hepatectomy should be avoided as far as possible.

Key words: Hepatectomy, Timing of surgery, Hepatolithiasis