Favorable outcomes of hilar duct oriented hepatic resection for high grade Tsunoda type hepatolithiasis

瞄准：评估门管的功效为难处理的肝石病的面向的肝切除术，被作者使用了的腹的核暴露(VHE ) 方法。方法：从 1994 年 6 月到为 10 年的一个时期的 2004 年 6 月，有 Tsunoda 的 153 个病人打 III 或 IV 肝石病，在我们的机构的收到的肝切除术。在这些病人之中， 128 由 VHE 方法经历了肝切除术的人，是为学习的题目。我们分析了这个过程， intra 肝的石头的剩余率，和石头的风险周期性的率。结果：平均年龄是 54.2 年，并且到女比率的男性是 1:1.7。平均后续时期是 25.6 瞬间(6-114 瞬间) 。在操作以后没有手术后的严重复杂并发症或死亡。剩余石头的率是 5.4% ，周期性的石头的率是 4.2% 。结论：VHE 是一个安全外科的过程并且提供难处理的肝石病的有利治疗结果。特别，这个过程有优点因为 intra 肝的胆汁管苛评可以在外科期间直接被证实并且改正。

AIM： To evaluate the efficacy of hilar duct oriented hepatectomy for intractable hepatolithiasis, the ventral hilum exposure （VHE） method that has been applied by the authors. METHODS： From June 1994 to June 2004 for a period of 10 years, 153 patients who had Tsunoda type Ⅲ or Ⅳ hepatolithiasis, received hepatectomy at our institution. Among these patients, 128 who underwent hepatectomy by the VHE method were the subjects for the study. We analyzed the risk of this procedure, residual rate of intrahepatic stones, and stone recurrent rates. RESULTS： The average age was 54.2 years, and the male to female ratio was 1：1.7. The average follow-up period was 25.6 mo （6-114 too）. There was no postoperative severe complication or mortality after the operation. The rate of residual stones was 5.4% and the rate of recurrent stones was 4.2%. CONCLUSION： VHE is a safe surgical procedure and provides favorable treatment results of intractable hepatolithiasis. Especially, this procedure has advantage in that intra-hepatic bile duct stricture may be confirmed and corrected directly during surgery.