Hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation

Abstract

Objective We found that the angle between the right posteroinferior bile duct and the longitudinal axis of the human body was smaller in the patients with stones in the bile duct. This study aimed to reveal the effect of hepatectomy combined with postoperative postural drainage for hepatolithiasis with right posteroinferior bile duct angulation. Methods All the patients with stones in the right posteroinferior bile duct and the angle mentioned above < 44.58°admitted into our institute from January 2011 to July 2016 were enrolled in the retrospective study. According to undergoing the postural drainage after surgery or not, they were divided into control group (n=81) and drainage group (n=84). Clinical data, intraoperative indexes, postoperative outcome, incidence of complications, and recurrence of bile duct stone were analyzed and compared between the 2 groups. Results There were no significant differences in preoperative general characteristics and surgical complications between the control group and postural drainage group. But the former group had obviously higher stone recurrence rate (P < 0.001), recurrence rate of acute cholangitis (P < 0.001), and cumulative recurrence rates of right posteroinferior bile duct stone (P=0.021) when compared with latter group during the follow-up period. Conclusion Hepatectomy combined with postoperative postural drainage can effectively reduce the recurrence rate of postoperative cholangitis and bile duct stone in patients with hepatolithiasis accompanied by angulation of the right posteroinferior bile duct.

Keywords

• hepatolithiasis
• recurrence of stone
• angulation of right posteroinferior bile duct
• postural drainage