Comparison of post-operative morbidity of cholangitis and recurring rate of hepatolithiasis between STHG and SLCJ

Objective To evaluate the long term effects of subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder (STHG) and subcutaneous blindloop cholangio jejunostomy (SLCJ). Methods The patients with hepatolithiasis treated by STHG or SLCJ between Dec. 1994 and Nov. 2000 in our hospital were followed up to determine the post operative morbidity of cholangitis and recurring rate of hepatolithiasis. Results During the 6 years 148 patients were followed up for an average of 3 years and 11 months. The postoperative morbidity of cholangitis was 5 4% (3/56) and 21 7% (20/92) and recurring rate of hepatolithiasis 3 6% (2/56) and 17 4% (16/92) in STHG group and SLCJ group, respectively. There were significant differences between the 2 groups. Such factors related to formation of hepatolithiasis as the age, gender, ratio of patients with lobectomy of liver, type of hepatolithiasis, stenosis of bile, jaundice happening before the operation and dystrophia etc. were not significantly different between the 2 groups. Conclusions Patients undergoing STHG have the better outcome. The main cause for which is that the function of Oddi's sphincter is maintained and the spacious tunnel is built between gallbladder and bile duct so that the function of gallbladder such as concentration, absorption and emptying etc. can be normal. Therefore, STHG should be the better choice for the patients with normal gallbladder and Oddi's sphincter.