RISK FACTORS FOR POOR LONG-TERM PROGNOSIS OF PATIENTS WITH INTRAHEPATIC BILE DUCT STONE AFTER MINIMALLY INVASIVE LEFT HEPATECTOMY

Fan Ouyang^{1, #}, Zhijian Meng^{1, #}, Dequan Jiang^{2, *}

¹Department of Operating Room, Wuhan No.1 Hospital, Wuhan, Hubei, 430000, PR China - ²Department of the second lesion of general surgery, Jiangjin central hospital of Chongqing, Jiangjin District, Chongqing, 402260, PR China

Objective: To investigate the risk factors for poor long-term prognosis of patients with intrahepatic bile duct stones after minimally invasive left hepatectomy. 

Methods: 324 patients with intrahepatic bile duct stones after minimally invasive left hepatectomy in our hospital from January 2012 to June 2018 were included in this study. After a 2-year follow-up in all patients, 288 cases with excellent and good quality of life were set as Group A and 36 cases with poor quality of life or death were set as Group B. The baseline clinical characteristics of two groups were compared, and a logistic regression model was used to evaluate the risk factors for poor long-term prognosis. 

Results: 324 patients were followed up for 25~72 months, with a median follow-up of 31.0 months. There were 30 cases of residual stones, 24 cases of recurrent stones, 36 cases of recurrent cholangitis and 9 cases of death. There were significant differences between the two groups in terms of gender, pro-portion of previous hepatobiliary surgery, Scr, ALP, APTT, proportions of combined choledochoscopy, biliary drainage, operation time and residual stones (P<0.05). A multivariate analysis by logistic regression model showed that previous hepatobiliary surgery, biliary drainage and operation time ≥232min were independent risk factors for poor long-term prognosis of patients with hepatolithiasis after minimally invasive left hepatectomy (P<0.05). 

Conclusion: The poor long-term prognosis of patients with hepatolithiasis after minimally invasive left hepatectomy is closely related to the previous hepatobiliary surgery, biliary drainage and operation time ≥232min. Clinicians should pay attention to the above factors when formulating surgical procedures and evaluating long-term prognosis and more active and reasonable treatment measures should be taken to improve the long-term prognosis.