Analysis of ReOperation for Hepatolithiasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

KER Chenguo ¹ , CHEN Hongjaw ¹ , JUAN Chungchou ¹ , CHEN Jongshan ² , LEE Kingter ² , SHEEN Paiching ²

Division of HBP Surgery, Center of HepatoGastroenterology, Yuan’s General Hospital, Kaohsiung 80211, Taiwan;

Corresponding author：

Keywords：

HepatolithiasisCholelithiasisCholangitis

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Objective To investigate the recurrence of hepatolithiasis and reoperation and their relation to the location of intrahepatic stone. MethodsTwo hundred and twentysix patients of hepatolithiasis operated upon in the period of 1990-1995 were retrospectively analysed.ResultsAmong those patients, there were 101 patients (44.7%) had previous operation for the gallstones diseases including cholecystectomy for gallbladder stones (n=21, 20.8%), choledocholithotomy (n=72, 71.3%),liver segmentectomy (n=6， 5.9%), and choledochojejunostomy (n=2, 2.0%). The operative mortality was 5.0% for the reoperation group and none for the first time operation for hepatolithiasis.Conclusion Although the liver resection is an ideal surgical method to eradicate the diseased lesion and to minimize the malignant changes especially in primary hepatolithiasis (type I, or IE)， choledochojejunostomy is only recommended for the secondary type (type IE or IE) where possible. In the management of hepatolithiasis, the complete information of biliary tract is needed for the choice of surgical methods.

Citation： KER Chenguo,CHEN Hongjaw,JUAN Chungchou,CHEN Jongshan,LEE Kingter,SHEEN Paiching. Analysis of ReOperation for Hepatolithiasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(5): 474-476. doi: Copy

1.	19Huang TJ, Ker CG. Left hepatic lobectomy for left intrahepatic stone [J]. J Surg Asso ROC, 1979; 12（4）∶305.
2.	Ker CG, Lee KT, Huang TJ, et al. Intrahepatic gallstones in Taiwan [J]. Southeast Asian J Surg, 1986; 9(1)∶42.
3.	Su CH, Lui WY, Peng FK. Relative prevalence of gallstone diseases in Taiwan. A nationwide cooperative study [J]. Dig Dis Sci, 1992; 37(5)∶764.
4.	Nakayama F, Koga A, Ichimiya H. Hepatolithiasis in East Asia: comparison between Japan and China [J]. J Gastroenterol Hepatol, 1991; 6(2)∶155.
5.	Fan ST, Lai EC, Wong J. Hepatic resection for hepatolithiasis [J]. Arch Surg, 1993; 128（9）∶1070.
6.	Kim SW, Park YH. Gallstone disease on Korea [J]. Asian J Surg, 1995; 18（2）∶86.
7.	Wen CC, Lee HC. Intrahepatic stones： a clinical study [J]. Ann Surg, 1972; 175(2)∶166.
8.	Tanimura H, Uchinoyama K, Isiyama H, et al. Epidemiology of hepatolithiasis [J]. J Biliary Tract&Pancrease, 1994; 15（5）∶401.
9.	Fan ST, Choi TK, Lo CM, et al. Treatment of hepatolithiasis: improvement of result by a systemic approach [J]. Surgery, 1991; 109(4)∶474.
10.	Ker CG, Sheen PC. Postoperative choledochoscopic removal of retained intrahepatic stones [J]. J Formosan Med Assoc, 1981; 90(2)∶158.
11.	Pitt HA, Venbrux AC, Coleman J, et al.Intrahepatic stones. The transhepatic team approach [J]. Ann Surg, 1994; 219(5)∶527.
12.	Jeng KS, Ohta I, Yang FS. Reappraisal of the systemic management of complicated hepatolithiasis with bilateral intrahepatic biliary strictures [J]. Arch Surg, 1996; 131(2)∶141.
13.	Ker CG, Luo KK, Tsai CC, et al. Evaluation of choledochojejunostomy with subcutaneous jejunostomy for treatment of intrahepatic stones [J]. Int Surg, 1994; 79(2)∶110.
14.	Lee KT, Sheen PC, Tsai CC, et al. Longterm results of one hundred and seven hepatic resections for intrahepatic stones [J]. Dig Surg, 1992; 19（2）∶298.
15.	Chijiiwa K, Yamashita H, Yoshida J, et al. Current management and longterm prognosis or hepatolithiasis [J]. Arch Surg, 1995; 130(2)∶194.
16.	Chijiiwa K, Kameoka N, Komura M, et al. Hepatic resection for hepatolithiasis and longterm results [J]. J Am Coll Surg, 1995; 180(1)∶43.
17.	Ho LC. Management of intrahepatic stones with special reference to RouxenY choledochojejunostomy: 1 to 15year followup study [J]. J Hep Bil Pancr Surg, 1995; 2(2)∶409.
18.	Takada T, Uchiyama K, Yasuda H, et al. Indications for the choledochoscopic removal of intrahepatic stones based on the biliary anatomy [J]. Am J Surg, 1996; 171(6)∶558.
19.	Jan YY, Chen MF, Wang CS, et al. Surgical treatment of hepatolithiasis: longterm results [J]. Surgery, 1996; 120(3)∶509.
20.	陈宝辉，罗海韻，柯成国，等. 肝内结石与肝内胆管癌 [J]. 肝胆胰， 1998； 37（2）∶181.
21.	Chang TM, Passaro E Jr. Intrahepatic stones： the Taiwan experience [J]. Am J Surg, 1983; 146（2）∶241.
22.	王雨，田伏洲，蔡忠红，等. 皮下通道型胆囊肝胆管成形术治疗肝胆管结石和胆管狭窄的中远期疗效观察 [J]. 中国普外基础与临床杂志， 2003； 10（1）∶ 58.
23.	SheenChen S, Chen W, Eng H, et al. Bacteriology and antimicrobial choice in hepatolithiasis [J]. Am J Infect Control, 2000; 28（4）∶298.
24.	Ker CG, Chen HY, Yang MY, et al. Occurrence of aerbic and anerobic bacterial species in the bile samples of patients with hepatolithiasis [J]. J Biomed & Lab Sci， 2002; 14（4）∶112.

1. 19Huang TJ, Ker CG. Left hepatic lobectomy for left intrahepatic stone [J]. J Surg Asso ROC, 1979; 12（4）∶305.
2. Ker CG, Lee KT, Huang TJ, et al. Intrahepatic gallstones in Taiwan [J]. Southeast Asian J Surg, 1986; 9(1)∶42.
3. Su CH, Lui WY, Peng FK. Relative prevalence of gallstone diseases in Taiwan. A nationwide cooperative study [J]. Dig Dis Sci, 1992; 37(5)∶764.
4. Nakayama F, Koga A, Ichimiya H. Hepatolithiasis in East Asia: comparison between Japan and China [J]. J Gastroenterol Hepatol, 1991; 6(2)∶155.
5. Fan ST, Lai EC, Wong J. Hepatic resection for hepatolithiasis [J]. Arch Surg, 1993; 128（9）∶1070.
6. Kim SW, Park YH. Gallstone disease on Korea [J]. Asian J Surg, 1995; 18（2）∶86.
7. Wen CC, Lee HC. Intrahepatic stones： a clinical study [J]. Ann Surg, 1972; 175(2)∶166.
8. Tanimura H, Uchinoyama K, Isiyama H, et al. Epidemiology of hepatolithiasis [J]. J Biliary Tract&Pancrease, 1994; 15（5）∶401.
9. Fan ST, Choi TK, Lo CM, et al. Treatment of hepatolithiasis: improvement of result by a systemic approach [J]. Surgery, 1991; 109(4)∶474.
10. Ker CG, Sheen PC. Postoperative choledochoscopic removal of retained intrahepatic stones [J]. J Formosan Med Assoc, 1981; 90(2)∶158.
11. Pitt HA, Venbrux AC, Coleman J, et al.Intrahepatic stones. The transhepatic team approach [J]. Ann Surg, 1994; 219(5)∶527.
12. Jeng KS, Ohta I, Yang FS. Reappraisal of the systemic management of complicated hepatolithiasis with bilateral intrahepatic biliary strictures [J]. Arch Surg, 1996; 131(2)∶141.
13. Ker CG, Luo KK, Tsai CC, et al. Evaluation of choledochojejunostomy with subcutaneous jejunostomy for treatment of intrahepatic stones [J]. Int Surg, 1994; 79(2)∶110.
14. Lee KT, Sheen PC, Tsai CC, et al. Longterm results of one hundred and seven hepatic resections for intrahepatic stones [J]. Dig Surg, 1992; 19（2）∶298.
15. Chijiiwa K, Yamashita H, Yoshida J, et al. Current management and longterm prognosis or hepatolithiasis [J]. Arch Surg, 1995; 130(2)∶194.
16. Chijiiwa K, Kameoka N, Komura M, et al. Hepatic resection for hepatolithiasis and longterm results [J]. J Am Coll Surg, 1995; 180(1)∶43.
17. Ho LC. Management of intrahepatic stones with special reference to RouxenY choledochojejunostomy: 1 to 15year followup study [J]. J Hep Bil Pancr Surg, 1995; 2(2)∶409.
18. Takada T, Uchiyama K, Yasuda H, et al. Indications for the choledochoscopic removal of intrahepatic stones based on the biliary anatomy [J]. Am J Surg, 1996; 171(6)∶558.
19. Jan YY, Chen MF, Wang CS, et al. Surgical treatment of hepatolithiasis: longterm results [J]. Surgery, 1996; 120(3)∶509.
20. 陈宝辉，罗海韻，柯成国，等. 肝内结石与肝内胆管癌 [J]. 肝胆胰， 1998； 37（2）∶181.
21. Chang TM, Passaro E Jr. Intrahepatic stones： the Taiwan experience [J]. Am J Surg, 1983; 146（2）∶241.
22. 王雨，田伏洲，蔡忠红，等. 皮下通道型胆囊肝胆管成形术治疗肝胆管结石和胆管狭窄的中远期疗效观察 [J]. 中国普外基础与临床杂志， 2003； 10（1）∶ 58.
23. SheenChen S, Chen W, Eng H, et al. Bacteriology and antimicrobial choice in hepatolithiasis [J]. Am J Infect Control, 2000; 28（4）∶298.
24. Ker CG, Chen HY, Yang MY, et al. Occurrence of aerbic and anerobic bacterial species in the bile samples of patients with hepatolithiasis [J]. J Biomed & Lab Sci， 2002; 14（4）∶112.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of ReOperation for Hepatolithiasis

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