LIVER RESECTION FOR NON-ORIENTAL HEPATOLITHIASIS

• Autor(a) principal: TORRES,Orlando Jorge Martins
• Data de Publicação: 2019
• Outros Autores: LINHARES,Marcelo Moura, RAMOS,Eduardo José B, AMARAL,Paulo Cezar G, BELOTTO,Marcos, LUCCHESE,Angelica Maria, NEIVA,Romerito Fonseca, FREITAS,Theago Medeiros, SANTANA,Rodolfo, VIEIRA,Josiel Paiva, FREIRE,Jaldo Santos, TORRES,Camila Cristina S, KALIL,Antonio Nocchi
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400302
• topic: Hepatolithiasis; intrahepatic lithiasis; Non-oriental; Liver resection; Hepatectomy

ABSTRACT Background: Primary intrahepatic lithiasis is defined when the stones are formed in the liver and associated with local dilatation and biliary stricture. Liver resection is the ideal procedure. Aim: To evaluate the results of liver resection in the treatment of non-oriental intrahepatic lithiasis. Methods: Fifty-one patients with symptomatic benign non-oriental hepatolithiasis underwent surgical resection in six institutions in Brazil. Demography data, clinical symptoms, classification, diagnosis, management and postoperative course were analyzed. Results: Of the 51 patients, 28 were male (54.9%), with a mean age of 49.3 years. History of cholangitis was observed in 15 (29.4%). The types of intrahepatic lithiasis were type I in 39 (76.5%) and type IIb in 12 (23.5%), with additional type Ea in six (11.8%). Liver function test were normal in 42 patients (82.4%). Segmental atrophy was observed in 12 (23.5%). Treatments included left lateral sectionectomy in 24 (47.1%), left hepatectomy in 14 (27.5%) and right hepatectomy in eight (15.7%), with associated hepaticojejunostomy in four (7.8%). Laparoscopic liver resection was performed in eight (15.7%). Postoperative complications were observed in 20 (39.2%) with no mortality. Conclusion: Liver resection in patients with hepatolithiasis is the ideal procedure as it removes stones, stricture, atrophic parenchyma, and minimizes the risk of cholangiocarcinoma.