Guanyu CHEN, Feng TIAN, Yu HE, et al. Hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation[J]. Journal of Third Military Medical University, 2021, 43(3): 239-243.
DOI:
Guanyu CHEN, Feng TIAN, Yu HE, et al. Hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation[J]. Journal of Third Military Medical University, 2021, 43(3): 239-243. DOI: 10.16016/j.1000-5404.202009049.
Hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation
We found that the angle between the right posteroinferior bile duct and the longitudinal axis of the human body was smaller in the patients with stones in the bile duct. This study aimed to reveal the effect of hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation.
Methods
2
All the patients with stones in the right posteroinferior bile duct and the angle mentioned above
<
44.58°admitted into our institute from January 2011 to July 2016 were enrolled in the retrospective study. According to undergoing the postural drainage after surgery or not
they were divided into control group (
n
=81) and drainage group (
n
=84). Clinical data
intraoperative indexes
postoperative outcome
incidence of complications
and recurrence of bile duct stone were analyzed and compared between the 2 groups.
Results
2
There were no significant differences in preoperative general characteristics and surgical complications between the control group and postural drainage group. But the former group had obviously higher stone recurrence rate (
P
<
0.001)
recurrence rate of acute cholangitis (
P
<
0.001)
and cumulative recurrence rates of right posteroinferior bile duct stone (
P
=0.021) when compared with latter group during the follow-up period.
Conclusion
2
Hepatectomy combined with postoperative postural drainage can effectively reduce the recurrence rate of postoperative cholangitis and bile duct stone in patients with hepatolithiasis accompanied by angulation of the right posteroinferior bile duct.
关键词
Keywords
references
LORIO E, PATEL P, ROSENKRANZ L, et al . Management of hepatolithiasis: Review of the literature[J ] . Curr Gastroenterol Rep, 2020, 22: 1-9. DOI: 10.1007/s11894-020-00765-3
PENG J X, WA NG L Z, DIAO J F, et al . Major hepatectomy for primary hepatolithiasis: a comparative study of laparoscopic versus open treatment[J ] . Surg Endosc, 2018, 32(10): 4271-4276. DOI:10.1007/s00464-018-6176-2.
CHEN G, WU J, XIAO L, et al . Right posteroinferior bile duct angulation correlates with bile duct stone occurrence in patients with hepatolithiasis[J ] . Abdom Radiol (NY), 2020, 45(10): 3103-3108. DOI:10.1007/s00261-020-02444-3.
UCHIYAMA K, KAWAI M, UENO M, et al . Reducing residual and recurrent stones by hepatectomy for hepatolithiasis[J ] . J Gastrointest Surg, 2007, 11(5): 626-630. DOI:10.1007/s11605-006-0024-8.
DEY B, KAUSHAL G, JACOB S E, et al . Pathogenesis and management of hepatolithiasis: a report of two cases[J ] . J Clin Diagn Res, 2016, 10(3): PD11-PD13. DOI: 10.7860/JCDR/2016/16752.7452
STAIN S C, NIGAM A. Management of recurrent cholangitis[M]//Difficult decisions in surgery: An evidence-based approach. Cham: Springer International Publishing, 2016: 227-239. DOI:10.1007/978-3-319-27365-5_20.
RAN X, YIN B, MA B. Four major factors contributing to intrahepatic stones[J]. Gastroenterol Res Pract, 2017, 2017: 7213043. DOI:10.1155/2017/7213043.