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学科主题临床医学
Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma for hepatolithiasis
Lian, Yu-Gui; Zhang, Wei-Tao; Xu, Zhi; Ling, Xiao-Feng; Wang, Li-Xin; Hou, Chun-Sheng; Wang, Gang; Cui, Long; Zhou, Xiao-Si
关键词Hepatolithiasis stone recurrence Sphincter of Oddi hepaticoplasty hepatectomy
刊名WORLD JOURNAL OF GASTROENTEROLOGY
2015-12-07
DOI10.3748/wjg.v21.i45.12865
21期:45页:12865-12872
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Gastroenterology & Hepatology
研究领域[WOS]Gastroenterology & Hepatology
关键词[WOS]INTRAHEPATIC STONES ; LIVER RESECTION ; LAPAROSCOPIC APPROACH ; WESTERN EXPERIENCE ; HEPATECTOMY ; OUTCOMES ; MANAGEMENT ; COHORT ; ERA
英文摘要

AIM: To evaluate the long-term outcomes of Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma (OSPCHS) and risk factors for recurrence in hepatolithiasis.

METHODS: From March 1993 to December 2012, 202 consecutive patients with hepatolithiasis underwent OSPCHS at our department. The Oddi sphincter preserved procedure consisted of common hepatic duct exploration, stone extraction, hilar bile duct plasty, establishment of subcutaneous stoma to the bile duct. Patients with recurrent stones can undergo stone extraction and/or biliary drainage via the subcutaneous stoma which can be incised under local anesthesia. The long-term results were reviewed. Cox regression model was employed to analyze the risk factors for stone recurrence.

RESULTS: Ninety-seven (48.0%) OSPCHS patients underwent hepatic resection concomitantly. The rate of surgical complications was 10.4%. There was no perioperative death. The immediate stone clearance rate was 72.8%. Postoperative cholangioscopic lithotomy raised the clearance rate to 97.0%. With a median follow-up period of 78.5 mo (range: 2-233 mo), 24.8% of patients had recurrent stones, 2.5% had late development of cholangiocarcinoma, and the mortality rate was 5.4%. Removal of recurrent stones and/or drainage of inflammatory bile via subcutaneous stoma were conducted in 44 (21.8%) patients. The clearance rate of recurrent stones was 84.0% after subsequent choledochoscopic lithotripsy via subcutaneous stoma. Cox regression analysis showed that residual stone was an independent prognostic factor for stone recurrence.

CONCLUSION: In selected patients with hepatolithiasis, OSPCHS achieves excellent long-term outcomes, and residual stone is an independent prognostic factor for stone recurrence.

语种英语
WOS记录号WOS:000365966600014
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/62622
专题北京大学第三临床医学院_普通外科
作者单位Peking Univ, Hosp 3, Dept Gen Surg, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
Lian, Yu-Gui,Zhang, Wei-Tao,Xu, Zhi,et al. Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma for hepatolithiasis[J]. WORLD JOURNAL OF GASTROENTEROLOGY,2015,21(45):12865-12872.
APA Lian, Yu-Gui.,Zhang, Wei-Tao.,Xu, Zhi.,Ling, Xiao-Feng.,Wang, Li-Xin.,...&Zhou, Xiao-Si.(2015).Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma for hepatolithiasis.WORLD JOURNAL OF GASTROENTEROLOGY,21(45),12865-12872.
MLA Lian, Yu-Gui,et al."Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma for hepatolithiasis".WORLD JOURNAL OF GASTROENTEROLOGY 21.45(2015):12865-12872.
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