腹腔镜解剖性肝Ⅲ段切除治疗左肝区域性肝内胆管结石临床效果OACSTPCD

Objective To investigate the surgery procedure points,indications,and feasibility of laparoscopic anatomical segment Ⅲ hepatectomy in the treatment of regional intrahepatic bile duct stones in the left liver.Methods A retrospective descriptive study was used to collect the data of 4 patients with intrahepatic bile duct stones limited to liver segment Ⅲ,who were admitted to Xiangya Changde Hospital(3 cases)and Xiangxi Tujia and Miao Autonomous Prefecture People's Hospital(1 case)between Aug.2021 and Oct.2022.Among 4 cases,1 was male and 3 were female,with a median age of 61.5(45.0-69.0)years old;2 cases were diagnosed with simple intrahepatic bile duct stones limited in liver segment Ⅲ,1 case was accompanied by gallbladder stones and common bile duct stones,and the other one was accompanied by gallbladder stones.All the 4 patients were treated with laparoscopic anatomical segment Ⅲ hepatectomy to remove intrahepatic bile duct stones in liver segmentⅢ.Results Laparoscopic anatomical segment Ⅲ hepatectomy was successfully performed in all 4 patients,and additional left hepatic vein reconstruction was performed in 1 case.The operation time was 280 min,440 min,220 min and 110 min,respectively.The first hepatic portal occlusion time was 60 min,60 min,75 min and 25 min,respectively.No case had blood transfusion.The postoperative hospitalization time was 12 d,10 d,9 d and 6 d,respectively.Liver dissection fluid occurred in 1 case,and conservative treatment was successfully applied.No complication occurred in other 3 cases.With a median follow-up of 19.5(10.0-24.0)months,no stone residue or related biliary symptom was found.Conclusion For patients with intrahepatic bile duct stones limited to liver segment Ⅲ,which meet specific anatomical conditions,laparoscopic anatomical segment Ⅲ hepatectomy is safe and feasible.