Treatment of non-endemic hepatolithiasis in a Western country: The role of hepatic resection

Marco Catena, Luca Aldrighetti, Renato Finazzi, Giandomenico Arzu, Marcella Arru, Carlo Pulitanò, Gianfranco Ferla

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: The aim of this study was to assess the safety and the efficacy of hepatic resective surgery in the treatment of single lobe hepatolithiasis. Patients and methods: Retrospective analysis and comparison between hepatic resections in patients with hepatolithiasis (hepatolithiasis group [HG]) and liver masses (control group [CG]). Seventeen consecutive Caucasian patients with single lobe hepatolithiasis (HG) and 30 patients with liver masses without chronic liver disease and previous chemotherapy (CG), were operated during the 5-year period 2000-2005, inclusive. Major hepatic resections including 4 right hepatectomies, 10 left hepatectomies, and 3 left lateral sectionectomy in HG, and 12 right hepatectomies, 3 extended right hepatectomy, 5 left hepatectomies, 4 left lateral sectionectomy, 5 bisegmentectomy, and 1 mesohepatectomy in CG. The main outcome measures were: type and length of surgical procedures, intra- and postoperative blood losses and transfusions (packed red blood cells [PRBC] and fresh frozen plasma [FFP]), intra- and postoperative course and complications (within 30 days of the operation), length of hospitalisation, histopathology, and recurrence of hepatolithiasis. Results: Mean operation time was 6.21 ± 2.38 h in HG versus 7.10 ± 2.21 h in CG (P = 0.33). Mean intra-operative blood loss in CG was higher than in HG (1010 ± 550 ml versus 560 ± 459 ml; P = 0.035). The other variables considered in the two groups were not statistically different. Intra-operative transfusion were 0.50 ± 0.85 units in HG versus 1.35 ± 2.25 units of PRBC in CG (P = 0.06), and 0.66 ± 1.34 units in HG versus 0.68 ± 1.20 units of FFP in CG (P = 0.44), respectively. No cases of death were registered. Postoperative complications occurred in 12 patients (25.5%) - 5 cases (10.6%) in HG and 7 cases (14.8%) in CG (P = 0.18). Mean postoperative transfusions were 0.47 ± 1.24 units in HG versus 1.10 ± 1.18 units of PRBC in CG (P = 0.35), and 0.65 ± 1.40 units in HG versus 0.46 ± 0.82 units of FFP in CG (P = 0.25), respectively. Difference in median hospitalisation was not statistically significant (14 ± 10 days versus 12 ± 9 days; P = 0.28). Histopathology showed cholangiocarcinoma in 2 cases (11.7%). During the follow-up period (range, 5-127 months; mean, 50.4 ± 41.9 months), 1 patient had lithiasis recurrence and 1 patient died for the co-existing cholangiocarcinoma. Conclusions: Hepatic resection is the treatment of choice in patients with single lobe hepatolithiasis. An early indication for surgery may reduce the mortality/morbidity rates of hepatic resection for hepatolithiasis.

Original languageEnglish
Pages (from-to)383-389
Number of pages7
JournalAnnals of the Royal College of Surgeons of England
Volume88
Issue number4
DOIs
Publication statusPublished - Jul 2006

Keywords

  • Hepatolithiasis
  • Resective surgery
  • Western country

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Treatment of non-endemic hepatolithiasis in a Western country: The role of hepatic resection'. Together they form a unique fingerprint.

Cite this