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- 저자 : ( Laligen Awale ) (검색결과 1 건)
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Review of Series of 9 Cases of Hepatolithiasis Managed at Community-Based Hospital of Nepal
( Sujan Gautam ),( Narendra Pandit ),( Laligen Awale ),( Kunal Bikram Deo ),( Tek Narayan Yadav ),( Shailesha Dhikary ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: Hepatolithiasis is a rare disease with high rate of treatment failure and recurrence. This study aims to review the management and outcome of hepatolithiasis from an endemic region. Methods: Retrospective review of prospectively maintained database of patients with hepatolithiasis managed surgically (2015- 2019) was performed. Diagnosis was based on the clinical findings and radiological investigation (CT/MRI). Demographic data, clinical presentation, extent of disease and operative procedure were evaluated. The outcome measures included immediate stone clearance, postoperative complications. Results: Hepatolithiasis was seen in nine (0.34%) out of 2,600 patients being evaluated for gallstone disease. Three patients were young, while the remaining six were in the middle-age group. Seven (78%) were females. The presenting symptoms were abdominal pain (78%) and jaundice (22%). Hepatolithiasis was located in the left, right and bilateral ductal systems in 5, 1 and 3 patients respectively. Concomitant cholelithiasis and choledocholithiasis was seen in 6 (66.6%) patients each. Liver resection for unilateral disease was done in 3 (33.3%) patients: left hepatectomy- (n=2) and left lateral segmentectomy (n=1). High bile duct exploration and bilio-enteric drainage was done in 5 patients. One patient required hepatolithotomy and T-tube drainage due to cholangitis. Complete stone clearance was achieved in 78% of patients. Complications included minor surgical site infection and cholangitis in two patients. Histopathology revealed recurrent pyogenic cholangitis. At median follow-up of 28 months, 78% are symptom-free. Conclusions: Hepatectomy is an effective treatment when disease is confined to the left lobe. Combined surgical procedure is an acceptable option for bilateral or right-sided hepatolithiasis.
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