Outcomes of Hepatectomy for Hepatolithiasis Based on 3-Dimensional Reconstruction Technique

BACKGROUND: The aim of our study was to evaluate the perioperative and long-term outcomes of hepatectomy based on 3-dimensional reconstruction technique for hepatolithiasis by comparing it with traditional hepatectomy. STUDY DESIGN: From December 2005 to September 2012, 56 consecutive patients underwent hepatectomy based on 3-dimensional reconstruction technique for hepatolithiasis in our hospital (group A). During the same period, 42 patients with hepatolithiasis who met the inclusion criteria for hepatectomy were selected for traditional hepatectomy (group B). All operations were performed by the authors. There was no significant difference in preoperative data between the 2 groups statistically. RESULTS: Compared with patients in group B, those in group A had a significantly lower stone residual rate (intermediate rate, 3.6% vs 19.0%; final rate, 0% vs 9.5%) and stone recurrence rate (3.6% vs 23.8%), a lower intrahepatic duct stricture residual rate (1.8% vs 14.3%), and a faster operating time (218.8 +/- 55.5 minutes vs 254.7 +/- 65.6 minutes). Intraoperative blood transfusion, intraoperative blood loss, postoperative hospital stay, and recurrent cholangitis rate were similar. No significant dominance was found in group A with respect to serum aminotransferase level, serum bilirubin level, serum albumin level, and prothrombin time. There was a significant dominance in group A for serum hemoglobin level (116.3 +/- 16.0 g/L vs 108.0 +/- 13.9 g/L; p < 0.05). Twenty-two complications occurred, 10 in group A and 12 in group B. Neither group had any perioperative mortality. CONCLUSIONS: Hepatectomy for hepatolithiasis based on 3-dimensional reconstruction technique is feasible and safe in selected patients. Compared with traditional hepatectomy, it is more effective for diagnosis and treatment of hepatolithiasis. (C) 2013 by the American College of Surgeons