BACKGROUND: Hepatic resection is an established procedure for treating
patients with hepatolithiasis. The long-term results after hepatic re
section for hepatolithiasis were appraised. STUDY DESIGN: Of 127 patie
nts with hepatolithiasis seen between 1973 and 1993, 43 patients under
went hepatic resection, and constituted the basis of this study. RESUL
TS: There was one operative death (operative mortality rate of 2.3 per
cent) and three deaths as a result of concomitantly associated cholang
iocellular carcinoma, Of the remaining 39 patients, the complete stone
clearance rate was 67 percent with operation alone, but reached 87 pe
rcent when cholangioscopy was used. Operative morbidity was recorded i
n five patients (12 percent), but they recovered with conservative the
rapy. Stones recurred in 15 percent of patients after a mean follow-up
period of four years (range of three to six years). Eleven (28 percen
t) of 39 patients died after hepatectomy as a result of related diseas
es after a mean follow-up of 6.2 years. These II patients had associat
ed biliary drainage procedures. They experienced a higher mortality ra
te (p<0.05) than patients who did not have biliary drainage. CONCLUSIO
NS: We conclude that hepatic resection is adequate treatment for hepat
olithiasis. The patients having additional biliary drainage procedures
had a higher mortality, but one cannot reach conclusions about the ne
gative effect of the drainage procedures because the drainage procedur
es were done in a selected and not a randomized manner.