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surgical techniques for hepatolithiasis

Xu-Dong Wen, Tao Wang, Zhu Huang, Hong-Jian Zhang, Bing-Yin Zhang, Li-Jun Tang, Wei-Hui Liu
Hepatolithiasis is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. The ultimate goal of hepatolithiasis treatment is the complete removal of the stone, the correction of the associated strictures and the prevention of recurrent cholangitis. Although hepatectomy could effectively achieve the above goals, it can be restricted by the risk of insufficient residual liver volume, and has a 15.6% rate of residual hepatolithiasis...
November 2017: Therapeutic Advances in Gastroenterology
Ahmet Öztürk, Mehmet Giray Sönmez, Süleyman Bakdık, Yunus Emre Göger, Mehmet Serkan Özkent, Faruk Aksoy, Metin Belviranlı
Intrahepatic bile duct stones may emerge with manifestations as chronic stomach ache, cholestasis, cholangitis, abscess, post-obstructive atrophy and liver cirrhosis presentation may occur. Thus the treatment of symptomatic hepatolithiasis patients should be provided. Different methods such as biliary decompression, endoscopic, percutaneous or open surgery are recommended for the treatment of patients with intrahepatic gallstones. The aim of the treatment is to extract the stones and regain biliary drainage...
September 2017: Turkish Journal of Urology
G W Ji, F P Zhu, X C Li
Hepatobiliary surgery is considered to be technically challenging because of complex intrahepatic and perihilar anatomical structures and variations.Nowadays, three-dimensional imaging technique plays an important role in the time of precise liver surgery.Three-dimensional images depict the spatial location of tumor, and the course, confluence pattern and variation of portal vein, hepatic artery, biliary system and hepatic vein distinctly while showing involved hepatic segments and the relationship with adjacent vessels from omnidirectional view, measuring the length of margin and future remnant liver...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Susumu Tazuma, Michiaki Unno, Yoshinori Igarashi, Kazuo Inui, Kazuhisa Uchiyama, Masahiro Kai, Toshio Tsuyuguchi, Hiroyuki Maguchi, Toshiyuki Mori, Koji Yamaguchi, Shomei Ryozawa, Yuji Nimura, Naotaka Fujita, Keiichi Kubota, Junichi Shoda, Masami Tabata, Tetsuya Mine, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012...
March 2017: Journal of Gastroenterology
Li-Bo Feng, Dong Xia, Lv-Nan Yan
Hepatolithiasis, originally as oriental cholangiohepatitis, especially prevails in Asia, but globalization and intercontinental migration have also converted the endemic disease dynamics around the world. Characterized by its high incidence of ineffective treatment and recurrence, hepatolithiasis, always, poses a therapeutic challenge to global doctors. Although the improved surgical and non-surgical techniques have evolved over the past decade, incomplete clearance and recurrence of calculi are always so common and disease-related mortality from liver failure and concurrent cholangiocarcinoma still exists in the treatment of hepatolithiasis...
June 2016: Clinical Transplantation
Tian-Chong Wu, Chi-Hua Fang, Wen-Ying Liu, Wei Cai, Ying-Fang Fan, Jian Yang, Ning Zeng, Shi-Zhen Zhong, Su-Su Bao
BACKGROUND/AIMS: Three-dimensional (3D) imaging may improve surgical interventions for complicated hepatolithiasis. METHODOLOGY: Between July 2008 and December 2012 a total of 131 patients with complicated hepatolithiasis underwent surgical therapy in the Department of Hepatobiliary Surgery Zhujiang Hospital, Southern Medical University. 77 patients received preoperative planning using a computed tomography (CT)-based 3D reconstruction technique, and 54 received treatment based on preoperative planning with traditional imaging (CT, ultrasonography, magnetic resonance imaging/magnetic resonance cholangiography)...
May 2014: Hepato-gastroenterology
Fu-Bao Liu, Xiao-Jun Yu, Guo-Bing Wang, Yi-Jun Zhao, Kun Xie, Fan Huang, Jiang-Ming Cheng, Xin-Rao Wu, Chao-Jie Liang, Xiao-Ping Geng
AIM: To investigate clinical features, treatment strategies and outcomes of patients with hepatolithiasis (HL) undergoing surgical treatment, using a new clinical classification. METHODS: Sixty-eight HL patients were hospitalized and treated surgically from August 2011 to December 2012 and they were classified into four HL types according to pathological evolution of the disease. These four HL types included type I primary type (defined as no previous biliary tract surgery), type II inflammatory type (with previous biliary tract surgery and cholangitis), type III mass-forming type (HL complicated by hepatic mass-forming lesion), and type IV terminal type (with secondary biliary cirrhosis and resultant portal hypertension)...
February 21, 2015: World Journal of Gastroenterology: WJG
Chi-Hua Fang, Gang Li, Ping Wang, Ying-Fang Fan, Shi-Zhen Zhong
BACKGROUND: Hepatolithiasis is challenging for surgeons to treat especially in patients with previous hepatobiliary surgery. The aim of the study was to report our experience of rigid choledochoscopy lithotripsy in targeted treatment of hepatolithiasis under the guidance of a medical image three-dimensional visualization system, which we developed and patented (software copyright no: 2008SR18 798) by comparing it with hepatectomy without a three-dimensional (3D) reconstruction technique...
May 1, 2015: Journal of Surgical Research
Ming-Gen Hu, Guo-Dong Zhao, Cai-Guo Ouyang, Da-Bin Xu, Rong Liu
OBJECTIVE: Laparoscopic hepatectomy is widely used in the surgical treatment of left-sided hepatolithiasis (LSH). Lithotomy using a cholangioscope usually is required for the treatment of concurrent right-sided hepatolithiasis or choledocholithiasis. The primary objective of this study was to evaluate the effectiveness and safety of gallstone elimination using cholangioscopy through the left hepatic duct (LHD) orifice versus the common bile duct (CBD). PATIENTS AND METHODS: Eligible LSH patients (n=41) were scheduled for laparoscopic left lateral segmentectomy or left hemihepatectomy with intraoperative biliary exploration using cholangioscopy through the LHD orifice (LHD group, n=23) or the CBD (CBD group, n=18) at the discretion of patients...
April 2013: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Aowen Xie, Chihua Fang, Yanpeng Huang, Yinfang Fan, Jiahui Pan, Fengping Peng
BACKGROUND AND AIM: Hepatolithiasis often requires repeated operations in East Asia. This study aims to evaluate the clinical application of three-dimensional reconstruction and visible simulation techniques for repeated operation in patients with intrahepatic calculi. METHODS: A medical image processing system was used for modeling, segmentation, and three-dimensional reconstruction of intrahepatic stones in 20 patients, consisting of 7 males and 13 females who were subjected to repeated surgical treatment from May 2010 to November 2011...
February 2013: Journal of Gastroenterology and Hepatology
Chihua Fang, Jianxin Chen, Yingfang Fan, Jian Yang, Nan Xiang, Jinhua You
OBJECTIVE: To assess the value of protective hepatectomy based on three-dimensional (3D) reconstruction technique in the treatment of hepatolithiasis. METHODS: The image data of 64-slice spiral CT scan were obtained from 21 patients with hepatolithiasis and processed using the MI-3DVS software for 3D reconstruction and visible simulation surgery of protective hepatectomy. The actual protective hepatectomy for hepatolithiasis was performed based on the preoperative surgical plan according to the 3D model and the simulation hepatectomy...
June 2012: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Zhe-Yu Chen, Lü-Nan Yan, Yong Zeng, Tian-Fu Wen, Bo Li, Ji-Chun Zhao, Wen-Tao Wang, Jia-Yin Yang, Ming-Qing Xu
BACKGROUND: Liver transplantation in Budd-Chiari syndrome remains controversial; however, some improved techniques lead to better results. We report medium-term follow-up results of liver transplantation with atrioatrial anastomosis for Budd-Chiari syndrome and explore the indications of liver transplantation with atrioatrial anastomosis for patients with end stage liver disease. METHODS: Nine patients (six Budd-Chiari syndromes, one end stage hepatolithiasis, one hepatocellular carcinoma and one incurable alveolar echinococcosis) underwent liver transplantation with atrioatrial anastomosis in West China Hospital of Sichuan University from 1999 to 2006...
December 2010: Chinese Medical Journal
Ying-fang Fan, Nan Xiang, Chi-hua Fang
OBJECTIVE: To assess the clinical value of digitalized minimally invasive technique in the treatment of the hepatolithiasis. METHODS: The 64-slice spiral CT data were acquired from 4 hepatolithiasis patients for three-dimensional reconstruction and simulation operation using abdominal medical image-3D visualization system (MI-3DVS). Three-dimensional reconstruction was performed for the liver, hepatic arteries, hepatic veins, portal veins, intrahepatic bile ducts and calculi...
October 2011: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
M A Machado, R C Surjan, F F Makdissi
AIM: To present a video of laparoscopic right hepatectomy using Glissonian technique. A new strategy for liver transection is presented. Liver is divided in three parts. The posterior part, containing short hepatic veins, is divided with stapler before liver transection. Anterior part is fully divided with harmonic scalpel, and the middle part, containing hepatic veins from segments 5 and 8, is the last part to be transected. PATIENT AND METHOD: A 41-year-old woman with right-sided hepatolithiasis and choledocholithiasis was referred for surgical treatment...
December 2011: Surgical Endoscopy
Ying-fang Fan, Chi-hua Fang, Jian-xin Chen, Nan Xiang, Jian Yang, Ke-xiao Li
OBJECTIVE: To assess the value of three-dimensional (3D) visualization technique in preoperative diagnosis, preoperative evaluation and surgical guidance for hepatolithiasis. METHODS: The 64-slice spiral CT data of 30 hepatolithiasis cases were imported in a self-designed medical image processing system for 3D reconstruction of the intrahepatic bile duct. The preoperative diagnosis and pathological classification were derived from the reconstructed model, with which the feasibility and safety of the surgical plan were assessed by simulation of the surgical procedures...
June 2011: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Derick J Christian, Amit Khithani, D Rohan Jeyarajah
Hepatic surgery has evolved significantly in the past decade. The current article describes the largest series of patients in United States undergoing liver resective therapy with the use of microwave technology for liver precoagulation. Glisson's capsule was incised after securing inflow and outflow control. Two antennae, 2 cm apart, connected to a 915-MHz generator, were inserted 5 cm into liver parenchyma at a 130° angle. Once the parenchyma was firm and changed its color to gray, the antennae were advanced along the line of transection...
April 2011: American Surgeon
Xiao-Jin Zhang, Yi Jiang, Xu Wang, Fu-Zhou Tian, Li-Zhi Lv
BACKGROUND: Optimal surgical technique plays a key role in preventing the postoperative recurrence of hepatolithiasis. Tian et al developed the subcutaneous tunnel and hepatocholangioplasty using the gallbladder (STHG) technique and applied it in hepatolithiasis patients who had an approximately normal gallbladder and sphincter of Oddi. However, the technique is controversial. In the present study, a canine model was established for hepatocholangioplasty (HC) and hepaticojejunostomy (HJ) to simulate STHG and Roux-en-Y cholangiojejunostomy in the clinic, respectively...
February 2010: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Zhi-qiang Huang, Li-ning Xu, Tao Yang, Wen-zhi Zhang, Xiao-qiang Huang, Shou-wang Cai, Ai-qun Zhang, Yu-quan Feng, Ning-xin Zhou, Jia-hong Dong
BACKGROUND: Hepatectomy is a standard hepatic surgical technique. The safety of hepatectomy has been improved in line with improvements in surgical techniques. This study analyzed the operative and perioperative factors associated with hepatectomy. METHODS: A total of 2008 patients who underwent consecutive hepatectomies between January 1986 and December 2005 were investigated retrospectively. Diagnoses were made based on pathological findings. RESULTS: Malignant and benign liver diseases accounted for 58...
October 5, 2009: Chinese Medical Journal
Zhi-qiang Huang, Xiao-qiang Huang, Wen-zhi Zhang, Li-ning Xu, Tao Yang, Ai-qun Zhang, Jia-hong Dong
OBJECTIVE: To analyze operative and perioperative factors associated with hepatectomy in hepatolithiasis. METHODS: 245 consecutive hepatolithiasis patients undergoing hepatectomy from January 1986 to December 2005 at Chinese People's Liberation Army General Hospital were investigated retrospectively according to medical documentation. RESULTS: Hepatolithiasis accounted for 29.6% (245/827) in all benign liver diseases treated with hepatectomy during this time period...
October 1, 2008: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Zhi-qiang Huang, Li-ning Xu, Tao Yang, Wen-zhi Zhang, Xiao-qiang Huang, Rong Liu, Shou-wang Cai, Ai-qun Zhang, Yu-quan Feng, Ning-xin Zhou, Jia-hong Dong
OBJECTIVE: To analyze operative and perioperative factors associated with hepatectomy. METHODS: 2008 consecutive patients undergoing hepatectomy from January 1986 to December 2005 at Chinese People's Liberation Army General Hospital were investigated retrospectively according to their medical documentation. Diagnoses were made on basis of pathological results. RESULTS: Malignant and benign liver diseases accounted for 58.5% and 41.2%, respectively...
September 1, 2008: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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