Young Ki Kim1, Ho-Seong Han, Yoo-Seok Yoon, Jai Young Cho, Woohyung Lee. 1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea, gsurgeon80@gmail.com.
Abstract
BACKGROUND: Despite several attempts to treat intrahepatic duct (IHD) stones by laparoscopy, most cases have been limited to left-sided IHD stones. The aim of this study was to evaluate the therapeutic feasibility and effectiveness of a laparoscopic approach for right-sided IHD stones compared with the open approach for this disease. METHODS: This study included 34 consecutive patients who underwent laparoscopic (n = 17) and open (n = 17) treatment for right-sided IHD stones from March 2005 to December 2011. Clinical data including the operative time, intraoperative blood loss, postoperative hospital length of stay, postoperative complications, stone clearance, and recurrence rate were retrospectively analyzed and compared between the two groups. RESULTS: Of the 17 patients who underwent laparoscopic treatment, three were treated using laparoscopic intrahepatic duct exploration alone and 14 patients were treated using laparoscopic liver resection. The operative time in the laparoscopic group was longer than that in the open group (432 ± 158 vs. 335 ± 85 min, p = 0.03). The laparoscopic group showed a lower postoperative complication rate than the open group (29 vs. 64 %, p = 0.039). There were no significant differences in intraoperative blood loss (988 ± 929 vs. 879 ± 942 ml, p = 0.737) or postoperative length of hospital stay (16 ± 22 vs. 12 ± 14 days, p = 0.221). CONCLUSIONS: This study demonstrated that laparoscopic treatment could be an effective and safe therapeutic modality in selected patients with right-sided IHD stones.
BACKGROUND: Despite several attempts to treat intrahepatic duct (IHD) stones by laparoscopy, most cases have been limited to left-sided IHD stones. The aim of this study was to evaluate the therapeutic feasibility and effectiveness of a laparoscopic approach for right-sided IHD stones compared with the open approach for this disease. METHODS: This study included 34 consecutive patients who underwent laparoscopic (n = 17) and open (n = 17) treatment for right-sided IHD stones from March 2005 to December 2011. Clinical data including the operative time, intraoperative blood loss, postoperative hospital length of stay, postoperative complications, stone clearance, and recurrence rate were retrospectively analyzed and compared between the two groups. RESULTS: Of the 17 patients who underwent laparoscopic treatment, three were treated using laparoscopic intrahepatic duct exploration alone and 14 patients were treated using laparoscopic liver resection. The operative time in the laparoscopic group was longer than that in the open group (432 ± 158 vs. 335 ± 85 min, p = 0.03). The laparoscopic group showed a lower postoperative complication rate than the open group (29 vs. 64 %, p = 0.039). There were no significant differences in intraoperative blood loss (988 ± 929 vs. 879 ± 942 ml, p = 0.737) or postoperative length of hospital stay (16 ± 22 vs. 12 ± 14 days, p = 0.221). CONCLUSIONS: This study demonstrated that laparoscopic treatment could be an effective and safe therapeutic modality in selected patients with right-sided IHD stones.