Multiple segmentectomy under selective occlusion of hepatic inflow for complicated intrahepatlc cholangiolithiasis

/Zhang Yuhua

(張宇華，Dept Gen Surg，Zhejiang Provin Peop Hosp，Hangzhou 310014)…∥Chin JGen Surg.-2011，26(8).-641～643

ObjectiveTo evaluate the result of multiple segmentectomy under selective occlusion of hepatic inflow for complicated intrahepatic cholangiolithiasis.MethodsIn this study 12 cases of complicated intrahepatic cholangiolithiasis receiving multiple segmentectomy under selective occlusion of hepatic inflow during 2004.1-2010.10 were reviewed retrospectively.The short-term and long-term outcomes of the patients were analyzed.ResultsThere was no surgical mortality in this group.The segmentectomy performed wereⅡ+Ⅲ+Ⅴin 1 case;Ⅱ+Ⅲ+Ⅵin 2 cases;Ⅱ+Ⅲ+Ⅴ+Ⅵin 1 case;Ⅱ +Ⅲ+Ⅵ +Ⅶin 4 cases;Ⅱ +Ⅲ +Ⅳ+Ⅵin 3 cases andⅡ +Ⅲ +Ⅳ +Ⅵ +Ⅶin 1 case.The average intraoperative blood loss was 560 ±291 ml.Postoperative complications were wound infection in 2 cases，bile leakage in 1 case，abdominal infection in 1 case.There were no liver failure，intrabdominal hemorrhage or hemobilia;stone clearance rate at 10 days after operation was 83%(10/12)and 92%(11/12)at 6 weeks after operation following postoperative choledochoscopic lithotripsy.92%(11/12)cases were followedup with the median follow-up period of 31 months.The result was excellent or good in 92%(11/12)cases.ConclusionMultiple segmentectomy was the choice for complicated intrahepatic cholangiolithasis，and the procedure could be safely performed under selective occlusion of the hepatic inflow.6 refs，1 tab