Yang YH, Li XJ, Liu YX, Wang XR, Li JW. Laparoscopic hepatectomy based on diseased bile duct tree territory guided by double landmarks for hepatolithiasis: A case report. World J Gastrointest Surg 2025; 17(8): 108959 [DOI: 10.4240/wjgs.v17.i8.108959]
Corresponding Author of This Article
Xing-Ru Wang, Professor, Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, No. 30 Gaotanyan Main Street, Shapingba District, Chongqing 400038, China. hongxing0060@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 108959 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.108959
Laparoscopic hepatectomy based on diseased bile duct tree territory guided by double landmarks for hepatolithiasis: A case report
Yue-Hua Yang, Xiao-Ju Li, Yi-Xuan Liu, Xing-Ru Wang, Jian-Wei Li
Yue-Hua Yang, Xing-Ru Wang, Jian-Wei Li, Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, Chongqing 400038, China
Xiao-Ju Li, Department of Hepatobiliary Surgery, Qujing Second People’s Hospital of Yunnan Province, Qujing 655000, Yunnan Province, China
Yi-Xuan Liu, School of Basic Medicine, Kunming Medical University, Kunming 650000, Yunnan Province, China
Co-first authors: Yue-Hua Yang and Xiao-Ju Li.
Co-corresponding authors: Xing-Ru Wang and Jian-Wei Li.
Author contributions: Yang YH and Li XJ contribute equally to this study as co-first authors; Wang XR and Li JW contribute equally to this study as co-corresponding authors; all authors contributed to the conception and design of this study; Li XJ and Liu YX performed material preparation, data collection, and analysis; The first draft of the manuscript was written by Wang XR, Yang YH and Li JW; Wang XR, Yang YH, and Li JW commented on the previous versions of the manuscript; all authors have read and approved the final manuscript.
Supported by Education Project of Yunnan Province, No. 2024J1628; and Project of Qujing Medical College in 2024, No. 2024XQ002.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xing-Ru Wang, Professor, Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, No. 30 Gaotanyan Main Street, Shapingba District, Chongqing 400038, China. hongxing0060@163.com
Received: April 28, 2025 Revised: May 30, 2025 Accepted: June 30, 2025 Published online: August 27, 2025 Processing time: 120 Days and 4.4 Hours
Abstract
BACKGROUND
Complex hepatolithiasis has a high perioperative risk and recurrence rate. Currently, standardized treatment protocols and reliable anatomical landmarks remain undefined, posing considerable challenges for laparoscopic hepatectomy in these cases. Achieving complete stone clearance and addressing hilar bile duct stenosis are critical determinants of surgical efficacy in hepatolithiasis management.
CASE SUMMARY
We present the case of a woman with intrahepatic and extrahepatic bile duct stones and chronic cholangitis who underwent laparoscopic hepatectomy. Hepatic segments I, II, III, IV, VI, and VII of the diseased bile duct tree and bile duct cyst were resected according to the preoperative plan, plastic repair of the hilar bile duct was performed, and the repaired bile duct was anastomosed with the jejunum. The patient achieved a favorable prognosis and long-term survival.
CONCLUSION
Based on segmental/subsegmental diseased bile duct tree territory hepatectomy and hilar stenosis relief, laparoscopic hepatectomy for complex hepatolithiasis can be safely performed guided by double landmarks (diseased bile duct/hepatic vein).
Core Tip: This study describes the complex case of a woman with intrahepatic and extrahepatic bile duct stones and chronic cholangitis who underwent laparoscopic hepatectomy. Laparoscopic hepatectomy for complex hepatolithiasis can be safely performed using double landmarks (diseased bile duct/hepatic vein).
