ses gallbladder have to be ablated in surgical treatment of hepatolithiasis

abstractjective To discuss the value of gallbladder for surgical treatment of hepatolithia-sis and explore the feasibility of reserving the gallbladder in the operatioa Methods The clinical data of 247 patients hepatolithiasis treated in our hospital between 1994 and 2002 were summarized to understand the cause of previous cholecystectomy and study the function of the gallbladder in patients with hepatolithiasis. A new approach, subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder (STHG), was introduced for treatment of hepatolithiasis. Results Of the 247 patients, 81 received cholecystectomy. The reasons for undergoing the operation were as follow: (1) 19 patients were misdiagnosed to suffer from cholecystitis; (2) 33 received the operation in choledocholithotomy; (3) 29 underwent in choledochojejunostomy. A total of 166 patients had gallbladder with them and 125 of them had normal gallbladder function. One hundred and two patients suffering from hepatolithiasis in combination with bile duct stricture underwent STHG. This new approach saved the gallbladder and its function. The gallbladder was anastomosed to the widely opened bile duct in the hilus to form a widened passway through intrahepatic to extrahepatic duct. The recurrence of pigment stone was prevented by increasing the concentration of bile acid in the intrahepatic bile duct. The Oddi's sphincter was saved so that the reflux from the jejunum to the bile duct was prevented. The fundus of gallbladder was mobilized and pulled into abdominal wall so that the subcutaneous tunnel was formed and could be used for re-entry to biliary tree at any time. Conclusions Most of the patients with hepatolithiasis have normal gallbladder. STHG can result in better outcome. This approach should be the first choice for the patients with hepatolithiasis having normal gallbladder and Oddi's sphincter.