Skip to main content

Advertisement

SpringerLink
Log in

Robotic Liver Resection For Primary Hepatolithiasis: Is It Beneficial?

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Primary hepatolithiasis is a disease characterized by primary biliary ductal abnormality with stone formation predominantly within the intrahepatic bile ducts. Its management is difficult, but liver resection has emerged as a promising treatment option.

Methods

Robotic liver resection (RLR) has been adopted in our center for the management of patients with hepatolithiasis. The operative and short-term outcomes of this cohort of patients were compared with a historical cohort of patients using open approach (OLR). A subgroup analysis was performed for left lateral sectionectomy.

Results

Between September 2010 and April 2015, 15 RLRs were performed on patients with primary hepatolithiasis. The historical cohort consisted of 42 OLRs with operation done between January 2005 and January 2014. No differences were found in patient demographics, disease characteristics, or types of resection. No operative deaths occurred, and no difference was seen in complication rates. RLR had significantly less blood loss (100 vs. 235 ml; p = 0.011) and shorter hospital stays (6 vs. 8 days; p = 0.003). After a median follow-up of 19.4 months for RLRs and 79.2 months for OLRs (p < 0.001), there were no differences in residual stone rate, recurrent stone rate, or rate of recurrent cholangitis. Subgroup analysis of lateral sectionectomy (10 RLRs vs. 27 OLRs) revealed similar outcomes, i.e., less blood loss and shorter hospital stays in RLR.

Conclusions

Robotic liver resection reduces blood loss and shortens hospital stays compared with OLR. A longer follow-up is needed to assess the long-term outcomes of RLR regarding prevention of recurrent stones and cholangitis.

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
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Digby KH (1930) Common-duct stones of liver origin. Br J Surg 17:578–591

    Article  Google Scholar 

  2. Cook J, Hou PC, Ho HC et al (1954) Recurrent pyogenic cholangitis. Br J Surg 42:188–203

    Article  CAS  PubMed  Google Scholar 

  3. Nakayama F, Furusawa T, Nakama T (1980) Hepatolithiasis in Japan: present status. Am J Surg 139:216–220

    Article  CAS  PubMed  Google Scholar 

  4. Lo CM, Fan ST, Wong J (1997) The changing epidemiology of recurrent pyogenic cholangitis. Hong Kong Med J 3:302–304

    PubMed  Google Scholar 

  5. Chen C, Huang M, Yang J et al (2005) Reappraisal of percutaneous transhepatic cholangioscopic lithotomy for primary hepatolithiasis. Surg Endosc 19:505–509

    Article  PubMed  Google Scholar 

  6. Chen DW, Poon RTP, Liu CL et al (2004) Immediate and long-term outcomes of hepatectomy for hepatolithiasis. Surgery 135:386–393

    Article  PubMed  Google Scholar 

  7. Cheung MT, Kwok PCH (2005) Liver resection for intrahepatic stones. Arch Surg 140(10):993–997

    Article  PubMed  Google Scholar 

  8. Lee TY, Chen YL, Chang HC et al (2007) Outcomes of hepatectomy for hepatolithiasis. World J Surg 31(3):479–482

    Article  PubMed  Google Scholar 

  9. Al-Sukhni W, Gallinger S, Pratzer A et al (2008) Recurrent pyogenic cholangitis with hepatolithiasis—the role of surgical therapy in North America. J Gastrointest Surg 12:496–503

    Article  PubMed  Google Scholar 

  10. Nuzzo G, Clemente G, Giovannini I et al (2008) Liver resection for primary intrahepatic stones: a single-centre experience. Arch Surg 143:570–573

    Article  PubMed  Google Scholar 

  11. Lee KF, Chong CN, Ng D et al (2009) Outcome of surgical treatment for recurrent pyogenic cholangitis: a single-centre study. HPB (Oxford) 11:75–80

    Article  Google Scholar 

  12. Uenishi T, Hamba H, Takemura S et al (2009) Outcomes of hepatic resection for hepatolithiasis. Am J Surg 198:199–202

    Article  PubMed  Google Scholar 

  13. Tang CN, Tai CK, Siu WT et al (2005) Laparoscopic treatment of recurrent pyogenic cholangitis. J Hepatobiliary Pancreat Surg 12:243–248

    Article  PubMed  Google Scholar 

  14. 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 

  15. Lee KF, Cheung YS, Chong CC et al (2016) Laparoscopic and robotic hepatectomy: experience from a single centre. ANZ J Surg 86:122–126. doi:10.1111/ans.13339

    Article  PubMed  Google Scholar 

  16. Strasberg SM (2005) Nomenclature of hepatic anatomy and resections: a review of Brisbane 2000 system. J Hepatobiliary Pancreat Surg 12:351–355

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ye X, Ni K, Zhou X et al (2015) Laparoscopic versus open left hemihepatectomy for hepatolithiasis. J Surg Res 199:402–406

    Article  PubMed  Google Scholar 

  19. Jin R, Wang Y, Yu H et al (2016) Total laparoscopic left hepatectomy for primary hepatolithiasis: eight-year experience in a single center. Surgery 159:834–841. doi:10.1016/j.surg.2015.09.022

    Article  PubMed  Google Scholar 

  20. Ding G, Cai W, Qin M (2015) Pure laparoscopic versus open liver resection in treatment of hepatolithiasis within the left lobes: a randomized trial study. Surg Laparosc Endosc Percut Tech 25:392–394

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Mr. Philip Ip for his assistance with data processing and statistical analysis.

Author information

Authors and Affiliations

  1. Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32, Ngan Shing Street, Shatin N.T., Hong Kong, SAR, China

    Kit-fai Lee, Anthony K. W. Fong, Charing C. N. Chong, Sunny Y. S. Cheung, John Wong & Paul B. S. Lai

Authors
  1. Kit-fai Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony K. W. Fong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charing C. N. Chong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sunny Y. S. Cheung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul B. S. Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kit-fai Lee.

Ethics declarations

Conflict of interest

All authors have no conflicts of interest or financial ties to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, Kf., Fong, A.K.W., Chong, C.C.N. et al. Robotic Liver Resection For Primary Hepatolithiasis: Is It Beneficial?. World J Surg 40, 2490–2496 (2016). https://doi.org/10.1007/s00268-016-3528-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-016-3528-8

Keywords

Search

Navigation