Total laparoscopic left hepatectomy for primary hepatolithiasis: Eight-year experience in a single center

Background. Primary hepatolithiasis is prevalent in some Asian countries. Hepatectomy is a definitive treatment for this disease. Whether laparoscopic left hepatectomy (LLH) is suitable for primary hepatolithiasis remains controversial, because LLH is more challenging technically. The aim of this study was to evaluate the outcomes of LLH for primary hepatolithiasis in a single center. Methods. This retrospective study included 96 consecutive patients who underwent LLH for primary hepatolithiasis in the Sir Run Run Shaw Hospital from May 2005 to December 2012. In addition, 105 patients who met the same inclusion criteria for LLH but underwent open left hepatectomy (OLH) for hepatolithiasis during the same period were reviewed for comparison. The patient characteristics, operative features, postoperative course, residual stone rate, and recurrent stone rate were analyzed. Results. In the LLH group, 81 patients (84.4%) underwent total LLH and 15 (15.6%) were converted to open hepatectomy. The volume of intraoperative blood loss was less in the LLH than OLH group (383 281 vs 554 517 mL; P =.005). The intraoperative transfusion rate was also significantly lower in the LLH group (8.3 % vs 30.5 %; P <.001). There were no differences between the LLH and OLH groups in operation time, duration of postoperative hospitalization, postoperative complication rate, residual stone rate, or recurrent stone rate. Conclusion. In experienced hands, total LLH is a safe, effective, and promising treatment for patients with hepatolithiasis.