Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
World Journal of Surgery
Published in: World Journal of Surgery 2/2016

01-02-2016 | Original Scientific Report

Liver Resection for Primary Intrahepatic Stones: Focus on Postoperative Infectious Complications

Authors: Gennaro Clemente, Agostino M. De Rose, Rita Murri, Francesco Ardito, Gennaro Nuzzo, Felice Giuliante

Published in: World Journal of Surgery | Issue 2/2016

Login to get access

Abstract

Background

Primary intrahepatic lithiasis is defined by the presence of gallstones at the level of cystic dilatations of the intrahepatic biliary tree. Liver resection is considered the treatment of choice, with the purpose of removing stones and atrophic parenchyma, also reducing the risk of cholangiocarcinoma. However, in consequence of the considerable incidence of infectious complications, postoperative morbidity remains high. The current study was designed to evaluate the impact of preoperative bacterial colonization of the bile ducts on postoperative outcome.

Methods

The clinical records of 73 patients treated with liver resection were reviewed and clinical data, operative procedures, results of bile cultures, and postoperative outcomes were examined.

Results

Left hepatectomy (38 patients) and left lateral sectionectomy (19 patients) were the most frequently performed procedures. Overall morbidity was 38.3 %. A total of 133 microorganisms were isolated from bile. Multivariate analysis identified previous endoscopic or percutaneous cholangiography (p = 0.043) and preoperative cholangitis (p = 0.003) as the only two independent risk factors for postoperative infectious complications.

Conclusions

Postoperative morbidity was strictly related to the preoperative biliary infection. An effective control of infections should be always pursued before liver resection for intrahepatic stones and an aggressive treatment of early signs of sepsis should be strongly emphasized.
Literature
1.
2.
Nuzzo G, Clemente G, Giovannini I et al (2008) Liver resection for primary intrahepatic stones: a single-center experience. Arch Surg 143:570–573PubMedCrossRef
3.
Tazuma S (2006) Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol 20:1075–1083PubMedCrossRef
4.
Mori T, Sugiyama M, Atomi Y (2006) Management of intrahepatic stones. Best Pract Res Clin Gastroenterol 20:1117–1137PubMedCrossRef
5.
Shoda J, Tanaka N, Osuga T (2003) Hepatolithiasis-epidemiology and pathogenesis update. Front Biosci 8:e398–e409PubMedCrossRef
6.
Chen DW, Poon RTP, Liu CL et al (2004) Immediate and long-term outcomes of hepatectomy for hepatolithiasis. Surgery 135:386–393PubMedCrossRef
7.
Kim BW, Wang HJ, Kim WH et al (2006) Favorable outcomes of hilar duct oriented hepatic resection for high grade Tsunoda type hepatolithiasis. World J Gastroenterol 12:431–436PubMedPubMedCentral
8.
Li SQ, Liang LJ, Peng BG et al (2007) Bile leakage after hepatectomy for hepatolithiasis: risk factors and management. Surgery 141:340–345PubMedCrossRef
9.
10.
Chen ZY, Yan LN, Zeng Y et al (2008) Preliminary experience with indications for liver transplantation for hepatolithiasis. Transpl Proc 40:3517–3522CrossRef
11.
Huang ZQ, Huang XQ, Zhang WZ et al (2008) Liver resection in hepatolithiasis: 20-year’s evolution. Zhonghua Wai Ke Za Zhi 46:1450–1452PubMed
12.
Uenishi T, Hamba H, Takemura S et al (2009) Outcome of hepatic resection for hepatolithiasis. Am J Surg 198:199–202PubMedCrossRef
13.
14.
Di Carlo I, Sauvanet A, Belghiti J (2000) Intrahepatic lithiasis: a Western experience. Surg Today 30:319–322PubMedCrossRef
15.
Kassahun WT, Kahn T, Wittekind C et al (2005) Caroli’s disease: liver resection and liver transplantation. Experience in 33 patients. Surgery 138:888–898PubMedCrossRef
16.
17.
Catena M, Aldrighetti L, Finazzi R et al (2006) Treatment of non-endemic hepatolithiasis in a western country. The role of hepatic resection. Ann R Coll Surg Engl 88:383–389PubMedPubMedCentralCrossRef
18.
Bockhorn M, Malagó M, Lang H et al (2006) The role of surgery in Caroli’s disease. J Am Coll Surg 202:928–932PubMedCrossRef
19.
Vetrone G, Ercolani G, Grazi GL et al (2006) Surgical therapy for hepatolithiasis: a western experience. J Am Coll Surg 202:306–312PubMedCrossRef
20.
Mabrut JY, Partensky C, Jaeck D et al (2007) Congenital intrahepatic bile duct dilation is a potentially curable disease: long-term results of a multi-institutional study. Ann Surg 246:236–245PubMedPubMedCentralCrossRef
21.
Ulrich F, Pratschke J, Pascher A et al (2008) Long-term outcome of liver resection and transplantation for Caroli disease and syndrome. Ann Surg 247:357–364PubMedCrossRef
22.
Clemente G, Giuliante F, De Rose AM et al (2010) Liver resection for intrahepatic stones in congenital bile duct dilation. J Visc Surg 147(3):e175–e180PubMedCrossRef
23.
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation of 6336 patients and results of surgery. Ann Surg 240:205–213PubMedPubMedCentralCrossRef
24.
Capussotti L, Ferrero A, Viganò L et al (2006) Bile leakage and liver resection: where is the risk? Arch Surg 141:690–694PubMedCrossRef
25.
Kamiya J, Kitagawa Y, Nimura Y (2007) Intrahepatic stones. In: Blumgart LH (ed) Surgery of the liver, biliary tract, and pancreas, 4th edn. Elsevier, Philadelphia, pp 586–596CrossRef
26.
Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236:397–407PubMedPubMedCentralCrossRef
27.
Imamura H, Seyama Y, Kokudo N et al (2003) One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg 138:1198–1206PubMedCrossRef
28.
Sun WB, Han BL, Cai JX (2000) The surgical treatment of isolated left-sided hepatolithiasis: a 22-year experience. Surgery 127:493–497PubMedCrossRef
29.
30.
Sugawara G, Nagino M, Nishio H et al (2006) Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery. Ann Surg 244:706–714PubMedPubMedCentralCrossRef
31.
Shigeta H, Nagino M, Kamiya J et al (2002) Bacteriemia after hepatectomy: an analysis of a single-center, 10-year experience with 407 patients. Langebecks Arch Surg 387:117–124CrossRef
32.
Huang ZQ, Xu LN, Yang T et al (2009) (2009): Hepatic resection: an analysis of the impact of operative and perioperative factors on morbidity and mortality rates in 2008 consecutive hepatectomy cases. Chin Med J 122:2268–2277PubMed
33.
Edwards JP, Ho AL, Tee MC et al (2012) Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials. Ann Surg 256:53–59PubMedCrossRef
Metadata
Title
Liver Resection for Primary Intrahepatic Stones: Focus on Postoperative Infectious Complications
Authors
Gennaro Clemente
Agostino M. De Rose
Rita Murri
Francesco Ardito
Gennaro Nuzzo
Felice Giuliante
Publication date
01-02-2016
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 2/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3227-x

Other articles of this Issue 2/2016

World Journal of Surgery 2/2016 Go to the issue

Original Scientific Report

The Global Burden of Esophageal Cancer: A Disability-Adjusted Life-Year Approach

Original Scientific Report

Universal Use of Intraoperative Nerve Monitoring by Recently Fellowship-Trained Thyroid Surgeons is Common, Associated with Higher Surgical Volume, and Impacts Intraoperative Decision-Making

Original Scientific Report

Factors that Can Promote or Impede the Advancement of Women as Leaders in Surgery: Results from an International Survey

Original Scientific Report

Severe Complications of Laparoscopic and Conventional Appendectomy Reported to the Finnish Patient Insurance Centre

Original Scientific Report

Extensive Adhesions in Living Donor Liver Transplantation: A Retrospective Analysis

Original Scientific Report

Does the Implantation Technique for Totally Implantable Venous Access Ports (TIVAPs) Influence Long-Term Outcome?