Abstract: Objective:To explore the clinical efficacy of laparoscopic left hemihepatectomy for the treatment of intrahepatic bile duct stones.
Methods:The clinical data of 30 patients with left intrahepatic bile duct stones who were admitted to the Second Affiliated Hospital of Nanchang University from June 2013 to June 2014 were retrospectively analyzed. All 〖HJ*3〗the patients underwent laparoscopic left hemihepatectomy by the Glisson intra and extra pedicles vascular inflow occlusion techniques together with the removal of choledocholithiasis and right bile duct stones, and T tube placement or laparoscopic primary suture of common bile duct were selected according to the condition of bile duct. All the 30 patients were readmitted to hospital and detected by color Doppler ultrasound (CDUS), computed tomography (CT) and T tube cholangiography at  postoperative month 1, and then received CDUS reexamination every 3 months. CT and MRI reexaminations were applied to patients with complication of residual stones if necessary. All the patients were followed up till July 2014.
Results〓All the 30 patients were treated by laparoscopic hepatectomy with left hemihepatic vascular inflow occlusion, including 5 with conversion to open surgery and 25 with  successful operation. The Glisson extra and intrapedicel vascular inflow occlusion techniques were used in 11 and 14 patients, respectively. The operation time and volume of blood loss were (158±85)minutes and (405±215)mL. Two patients received intraoperative blood transfusion. There were no residual stones in the 8 patients with choledocholithiasis by intraoperative choledochoscope, and primary suture of bile duct and T tube placement were done in 5 and 3 patients, respectively. No patients died. After operation, there were 2 patients with bile leakage and 1 with pleural effusion, and they were cured though drainage. One patient with subphrenic effusion was cured by B ultrasoundguided puncture and drainage. One patient had bleeding with the volume of blood loss of 500 mL, and was cured by conservative treatment. The duration of hospital stay in all the patients was (8.5±2.3)days. No bile leakage and abdomen infection were detected by outpatient examination. The time of followup was 1-12 months, without recurrence of stones.
Conclusion 〖JP3〗Laparoscopic left hemihepatectomy for the treatment of left intrahepatic bile duct stones is safe and feasible with satisfactory outcome.