Laparoscopic liver resection for localized primary intrahepatic bile duct dilatation

Am J Surg. 2010 Jan;199(1):131-5. doi: 10.1016/j.amjsurg.2008.12.027. Epub 2009 Apr 17.

Abstract

Background: Primary intrahepatic bile duct dilatation (IHBD) may present as a localized form in which resection of the affected liver can prevent immediate and late complications. Laparoscopy has gained large interest in liver surgery. It also allows a safe and efficient exploration of the common bile duct.

Methods: We performed 10 laparoscopic liver resections for localized IHBD, on 7 women and 3 men (mean age 47 years). Resections were 2 right hepatectomies, 4 left hepatectomies, and 4 left lateral sectionectomies. Three patients had associated common bile duct stones that were treated through intraoperative cholangioscopy.

Results: The mean operative time was 303.9 minutes. The mean blood loss was 217 mL. None of these patients required hand assistance or conversion to open surgery. One patient suffered a residual collection that was drained percutaneously. The postoperative course was uneventful in the other patients. The mean hospital stay was 5.3 days. No recurrence of cholangitis was observed during the follow-up period.

Conclusions: The laparoscopic treatment of IHBD is safe and should be performed by teams with expertise in both hepatobiliary surgery and laparoscopy.

MeSH terms

  • Adult
  • Aged
  • Bile Ducts, Intrahepatic / pathology
  • Bile Ducts, Intrahepatic / surgery*
  • Blood Loss, Surgical / physiopathology
  • Cholangitis / diagnosis
  • Cholangitis / surgery*
  • Cohort Studies
  • Dilatation, Pathologic / surgery
  • Female
  • Follow-Up Studies
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Preoperative Care
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome