Skip to main content
SpringerLink
Log in

Comparison of laparoscopic versus open left-sided hepatectomy for intrahepatic duct stones

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

An Erratum to this article was published on 05 May 2015

Abstract

Background

Laparoscopic hepatectomy for intrahepatic duct (IHD) stones is limited by technical difficulties caused by adhesion to adjacent tissue or distorted anatomy resulting from recurrent inflammation. This study compared perioperative and clinical outcomes in patients undergoing laparoscopic and open hepatectomy for left IHD stones.

Methods

From January 2002 to December 2013, 40 patients underwent laparoscopic left-sided hepatectomy [left hemihepatectomy (n = 7) or left lateral sectionectomy (n = 33)] and 54 patients without combined operations and previous operation histories underwent open left-sided hepatectomy [left hemihepatectomy (n = 24) or left lateral sectionectomy (n = 30)]. Their perioperative and clinical outcomes were compared, including stone clearance rates, stone recurrence rates, and median follow-up duration.

Results

There was no difference in age (56.8 ± 8.2 vs. 55.6 ± 9.6 years, p = 0.531), sex (1.0:4.0 vs. 1.0:1.8 male:female, p = 0.108), or BMI (22.8 ± 2.8 vs. 22.9 ± 3.0 kg/m2, p = 0.802) between the laparoscopic and open hepatectomy groups. Lateral sectionectomy was more frequent in the laparoscopic group (33/40 vs. 30/54, p = 0.010). Operation time (174.2 ± 56.6 vs. 210.4 ± 51.6 min, p = 0.002) and postoperative hospital stay (7.9 ± 2.6 vs. 14.3 ± 5.5 days, p < 0.001) were shorter in the laparoscopic group, and complication rate (17.5 vs. 40.7 %, p = 0.016), in particular surgical site infection rate (5.0 vs. 18.5 %, p = 0.052), was lower in the laparoscopic group than in the open hepatectomy group. Similar results were observed in the hemihepatectomy and lateral sectionectomy subgroups. There was no operation-related mortality. There were no significant differences in follow-up periods (48 ± 33.6 vs. 59.2 ± 41.7 months, p = 0.235) and rates of initial stone clearance (87.5 vs. 75.9 %, p = 0.159), final clearance (100 vs. 94.4 %, p = 0.130), and stone recurrence (2.5 vs. 5.6 %, p = 0.468).

Conclusion

Laparoscopic hepatectomy is safe and effective for well-selected patients with left IHD stones, when performed by experienced surgeons. Laparoscopic hepatectomy resulted in shorter operation time and postoperative hospital stay, and a lower postoperative morbidity rate, than open hepatectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Cheung MT, Kwok PC (2005) Liver resection for intrahepatic stones. Arch Surg 140:993–997

    Article  PubMed  Google Scholar 

  2. Huang MH, Chen CH, Yang JC et al (2003) Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis. Am J Gastroenterol 98:2655–2662

    Article  PubMed  Google Scholar 

  3. Lee SK, Seo DW, Myung SJ et al (2001) Percutaneous transhepatic cholangioscopic treatment for hepatolithiasis: an evaluation of long-term results and risk factors for recurrence. Gastrointest Endosc 53:318–323

    Article  PubMed  CAS  Google Scholar 

  4. Otani K, Shimizu S, Chijiiwa K et al (1999) Comparison of treatments for hepatolithiasis: hepatic resection versus cholangioscopic lithotomy. J Am Coll Surg 189:177–182

    Article  PubMed  CAS  Google Scholar 

  5. Uchiyama K, Kawai M, Ueno M et al (2007) Reducing residual and recurrent stones by hepatectomy for hepatolithiasis. J Gastrointest Surg 11:626–630

    Article  PubMed  Google Scholar 

  6. Yoon YS, Han HS, Shin SH et al (2009) Laparoscopic treatment for intrahepatic duct stones in the era of laparoscopy: laparoscopic intrahepatic duct exploration and laparoscopic hepatectomy. Ann Surg 249(2):286–291

    Article  PubMed  Google Scholar 

  7. Gagner M, Rogula T, Selzer D (2004) Laparoscopic liver resection: benefits and controversies. Surg Clin North Am 84(2):451–462

    Article  PubMed  Google Scholar 

  8. Simi M, Loriga P, Basoli A et al (1979) Intrahepatic lithiasis: study of thirty-six cases and review of the literature. Am J Surg 137:317–322

    Article  PubMed  CAS  Google Scholar 

  9. Koga A, Miyazaki K, Ichimiya H et al (1984) Choice of treatment for hepatolithiasis based on pathologic findings. World J Surg 8:36–40

    Article  PubMed  CAS  Google Scholar 

  10. Lee SE, Jang JY, Lee JM et al (2008) Selection of appropriate liver resection in left hepatolithiasis based on anatomic and clinical study. World J Surg 32(3):413–418

    Article  PubMed  Google Scholar 

  11. O’Rourke N, Fielding G (2004) Laparoscopic right hepatectomy: surgical technique. J Gastrointest Surg 8:213–216

    Article  PubMed  Google Scholar 

  12. Yoon YS, Han HS, Choi YS et al (2006) Total laparoscopic right posterior sectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 16:274–277

    Article  PubMed  Google Scholar 

  13. Cho JY, Han HS, Yoon YS et al (2009) Outcomes of laparoscopic liver resection for lesions located in right side of the liver. Arch Surg 144(1):25–29

    Article  PubMed  Google Scholar 

  14. Chen P, Bie P, Liu J et al (2004) Laparoscopic left hemihepatectomy for hepatolithiasis. Surg Endosc 18:717–718

    Article  PubMed  CAS  Google Scholar 

  15. Cai X, Wang Y, Yu H et al (2007) Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients. Surg Endosc 21:1074–1078

    Article  PubMed  Google Scholar 

  16. Namgoong JM, Kim KH, Park GC et al (2014) Comparison of laparoscopic versus open left hemihepatectomy for left-sided hepatolithiasis. Int J Med Sci 11(2):127–133

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Chang YR, Jang JY, Kwon W et al (2013) Changes in demographic features of gallstone disease: 30 years of surgically treated patients. Gut Liver 7(6):719–724

    Article  PubMed  PubMed Central  Google Scholar 

  18. Shaffer EA (2005) Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 7:132–140

    Article  PubMed  Google Scholar 

  19. Chen CH, Huang MH, Yang JC et al (2006) Prevalence and risk factors of gallstone disease in an adult population of Taiwan: an epidemiological survey. J Gastroenterol Hepatol 21:1737–1743

    Article  PubMed  Google Scholar 

  20. Everhart JE, Khare M, Hill M, Maurer KR (1999) Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology 117:632–639

    Article  PubMed  CAS  Google Scholar 

  21. Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL (2006) Central adiposity, regional fat distribution, and the risk of cholecystectomy in women. Gut 55:708–714

    Article  PubMed  PubMed Central  Google Scholar 

  22. Cuevas A, Miquel JF, Reyes MS, Zanlungo S, Nervi F (2004) Diet as a risk factor for cholesterol gallstone disease. J Am Coll Nutr 23:187–196

    Article  PubMed  Google Scholar 

  23. Lindström CG (1977) Frequency of gallstone disease in a well-defined Swedish population. A prospective necropsy study in Malmo. Scand J Gastroenterol 12:341–346

    Article  PubMed  Google Scholar 

  24. Laurent A, Cherqui D, Lesurtel M et al (2003) Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg 138(7):763–769 discussion 769

    Article  PubMed  Google Scholar 

  25. Lesurtel M, Cherqui D, Laurent A et al (2003) Laparoscopic versus open left lateral hepatic lobectomy: a case-control study. J Am Coll Surg 196(2):236–242

    Article  PubMed  Google Scholar 

  26. Rau HG, Buttler E, Meyer G et al (1998) Laparoscopic liver resection compared with conventional partial hepatectomy—a prospective analysis. Hepatogastroenterology 45(24):2333–2338

    PubMed  CAS  Google Scholar 

Download references

Disclosures

Drs. Yong Chan Shin, Jin-Young Jang, Mee Joo Kang, Woohyun Jung, Jihoon Chang, Ye Rim Chang and Sun-Whe Kim have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, South Korea

    Yong Chan Shin, Jin-Young Jang, Mee Joo Kang, Woohyun Jung, Jihoon Chang, Ye Rim Chang & Sun-Whe Kim

Authors
  1. Yong Chan Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jin-Young Jang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mee Joo Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Woohyun Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jihoon Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ye Rim Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sun-Whe Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jin-Young Jang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shin, Y.C., Jang, JY., Kang, M.J. et al. Comparison of laparoscopic versus open left-sided hepatectomy for intrahepatic duct stones. Surg Endosc 30, 259–265 (2016). https://doi.org/10.1007/s00464-015-4200-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-015-4200-3

Keywords

Search

Navigation