17. Kết quả cắt gan điều trị bệnh sỏi gan: Hồi cứu 45 ca bệnh tại Bệnh viện Bạch Mai

Abstract

Treatment of hepatolithiasis requires multidisciplinary coordination, but there is still a high rate of incomplete clearance of stones. Alternatively, liver resection has been proposed as a definitive treatment for segmental hepatolithiasis because it treats not only the stones, but also strictures and atrophic and inflammatory changes. The objective of the study is to describe the clinical characteristics and outcomes of hepatectomy to treat hepatolithiasis. We performed a retrospective study of patients undergoing liver resection due to stones at Bach Mai Hospital by a single surgeon from January 2016 to October 2023. Preoperative, intraoperative, and postoperative variables were evaluated. Results: A total of 45 patients underwent hepatectomy for hepatolithiasis. The mean ± standard deviation patient age was 52.3 ± 10.3 years (range: 31 - 78 years); male/female ratio was 2.4. The main presenting symptom was abdominal pain (88.9 %). Hepatic involvement was noted in the left lateral segment in 71.1% and bilaterally in 28.9% of subjects. The most frequent procedure was left lateral sectionectomy and left hepatectomy which was conducted in 93.3% and 6.7% of patients, respectively. The mean operative time was 130.2 ± 35.5 min (range: 80 - 240 min). The mean hospital stay was 8.8 ± 2.9 days (range: 6 - 16 days). Complete clearance of the biliary system was achieved in 43 (95.5%) patients. Postoperative morbidity was 17.8% and there were no postoperative deaths. Conclusion: anatomic hepatectomy is an effective method in localized hepatolithiasis patients with low morbidity and no mortality. Long-term follow-up is needed to determine the risk of complications and recurrence rate.