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Home > Journals > Panminerva Medica > Past Issues > Panminerva Medica 2001 June;43(2) > Panminerva Medica 2001 June;43(2):89-93



A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Frequency: Quarterly

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2001 June;43(2):89-93


Role of hepatic resection in the treatment of hepatolithiasis

Aldrighetti L., Arru M., Caterini R., Mukenge S., Ferla G.

From the Department of Surgery Scientific Institute H San Raffaele, Milan, Italy

Background. The aim of the present study was to eval­u­ate the safe­ty and the effi­ca­cy of hepat­ic resec­tion in the treat­ment of hep­a­tol­i­thi­a­sis ­with intra­he­pat­ic bil­iary stric­tures.
Methods. Experimental ­design: retrospective ­study. Setting: University hos­pi­tal, Italy. Patients: 6 con­sec­u­tive ­patients ­with sin­gle ­lobe hep­a­tol­i­thi­a­sis oper­at­ed on dur­ing the 4-­year peri­od 1994-98 inclu­sive. Interventions: major hepat­ic resec­tions (3 ­left hep­a­tec­to­mies, 2 ­left lobec­to­mies, 1 ­right hep­a­tec­to­my). Main out­come meas­ures: type and dura­tion of the sur­gi­cal pro­ce­dure, ­intra/post­op­er­a­tive ­blood loss­es, ­intra/post­op­er­a­tive ­course and com­pli­ca­tions, pathol­o­gy, and hep­a­tol­i­thi­a­sis recur­rence.
Results. Mean oper­a­tive ­time was 3.34±0.02 ­hrs (­range 3.0-4.3 ­hrs). Mean ­blood ­loss was 233±150 ml (­range 100-500 ml). No ­patient ­required ­intra/post­op­er­a­tive ­blood trans­fu­sions. No intra­op­er­a­tive com­pli­ca­tion was record­ed. Mean post­op­er­a­tive hos­pi­tal­iza­tion was 17±7 ­days (­range 6-28 ­days). Postoperative ­course was unevent­ful in 4 (66%) cas­es. No post­op­er­a­tive mor­tal­ity was record­ed. One pan­crea­titis and 1 bil­iary fis­tu­la ­occurred, for an over­all post­op­er­a­tive mor­bid­ity of 33%. Pathology ­showed cho­lan­gio­car­cin­o­ma in 2 cas­es (33%). During the fol­low-up peri­od (­range 3-48 ­months, ­mean 19.1±16.4 ­months), 1 ­patient had recur­rent cho­lan­gitis due to ­right ­lobe lithi­a­sis and 1 ­patient ­died for cho­lan­gio­car­cin­o­ma.
Conclusions. Hepat­ic resec­tion is the treat­ment of ­choice in ­patients ­with sin­gle ­lobe hep­a­tol­i­thi­a­sis and unre­ver­sible bil­iary stric­tures or pos­sible pres­ence of cho­lan­gio­car­cin­o­ma. An ear­ly indi­ca­tion for sur­gery may ­reduce the mor­tal­ity/mor­bid­ity ­rates of hepat­ic resec­tion for hep­a­tol­i­thi­a­sis.

language: English


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