关键词: 复杂肝内胆管结石, 胆管狭窄, 肝门, 肝蒂, 切除, 腹侧段

Abstract: The effects of resection of the ventral segment of the hepatic portal for complicated intrahepatic and extrahepatic bile duct stones with portal stenosis：a clinical study of 16 cases        LIU Chang-jun，WEN Hao-quan，YANG Li-shun，et al. Department of hepatobiliary surgery，the First Affiliated Hospital of Hunan Normal University Hunan Provincial People's Hospital，Changsha 410005，China
Corresponding author：LIU Chang-Jun，E-mail：liuchangjun712@163.com
Abstract    Objective    To explore the feasibility and outcome of resection of the ventral segment of the hepatic portal，for the treatment of complicated intrahepatic and extrahepatic bile duct stones with portal stenosis. Methods    To analyze the cilinical data such as stone clearance rate，complications，and follow-up results of 16 cases，with complicated intrahepatic and extrahepatic bile duct stones with portal stenosis who treated with resection of the ventral segment of the hepatic portal from January 2015 to August 2019 in Hunan Provincial People's Hospital retrospectively. Results    Among the 16 patients，7 cases received the resection of partial IVb segment of the liver; 3 cases received the resection of partial V segment of the liver; 4 cases received the resection of partial IVb and V segment of the liver; 2 cases received the resection of IVb and partial V segment of the liver. The operation was successful without death in hospital and serious complications. The postoperative follow-up time was 6~57 months，and all of patients had an excellent evaluation of therapeutic efficacy. There was no stenosis in primary and secondary bile ducts by postoperative cholangiography，but 7 cases exist stenosis in tertiary bile ducts with a few retained bile duct stone. 5 cases were not completely removed after postoperative choledochofiberscopy. Close follow-up showed no obvious clinical symptoms. Conclusion    The resection of the ventral segment of the hepatic portal is a safe and feasible method for the treatment of complicated intrahepatic and extrahepatic cholelithiasis with hilar stenosis，and it can fully expose the hilar bile duct.

Key words: complex intrahepatic cholelithiasis, bile duct stenosis, hepatic portal, hepatic pedicle, resection, ventral segment