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Long-Term Outcomes of Hepatectomy for Bilateral Hepatolithiasis with Three-Dimensional Reconstruction: A Propensity Score Matching Analysis.
- Source :
-
Journal of laparoendoscopic & advanced surgical techniques. Part A [J Laparoendosc Adv Surg Tech A] 2016 Sep; Vol. 26 (9), pp. 680-8. Date of Electronic Publication: 2016 Jul 15. - Publication Year :
- 2016
-
Abstract
- Purpose: Bilateral hepatolithiasis tends to show recurrent attacks, which may lead to liver damage and bile duct cancer. This study aimed to assess long-term outcome of hepatectomy for bilateral hepatolithiasis based on three-dimensional reconstruction.<br />Method: A total of 258 bilateral hepatolithiasis patients were enrolled in this retrospective study from January 2008 to October 2014. There are 74 individuals in Three-Divisional Visualization System (MI-3DVS) group (group A) and 74 individuals in non-MI-3DVS group (group B) after propensity score matching (PSM), respectively. Then, complication incidence, stone clearance, recurrence, and recurrence-free survival rates were compared between the two groups. Multivariate Cox analysis was used to test impact of MI-3DVS on recurrence-free survival (RFS).<br />Results: The Median (Range) volumes of intraoperative blood loss were 300 (30-1050) and 400 (50-1800) mL in group A and B, respectively (P = .037). Meanwhile, immediate clearance (77% versus 53%, P = .002) and final clearance (95% versus 80%, P = .007) rates were higher in group A compared with values obtained for group B. Multivariate Cox analysis showed non-MI-3DVS (HR = 2.00, 95% confidence interval [CI] = 1.02-3.95, P = .045) and patients with bilateral cirrhosis (Hazard Ratio [HR] = 10.60, 95% CI = 4.45-25.25, P < .001) were independent predictors of RFS.<br />Conclusion: Compared with conventional radiological technology, MI-3DVS-based hepatectomy resulted in higher stone clearance rate of bilateral hepatolithiasis patients. Non-MI-3DVS and patients with bilateral cirrhosis were independent predictors for recurrence-free survival.
- Subjects :
- Adult
Aged
Blood Loss, Surgical
Disease-Free Survival
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Complications etiology
Propensity Score
Recurrence
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Hepatectomy adverse effects
Hepatectomy methods
Imaging, Three-Dimensional methods
Lithiasis diagnostic imaging
Lithiasis surgery
Liver Diseases surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1557-9034
- Volume :
- 26
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of laparoendoscopic & advanced surgical techniques. Part A
- Publication Type :
- Academic Journal
- Accession number :
- 27420918
- Full Text :
- https://doi.org/10.1089/lap.2016.0165