Abstract: Objective To investigate the efficacy of pulse pressure variation （PPV）-guided fluid therapy in patients with hepatolithiasis underwent partial hepatectomy（PH）. Methods A total of 260 patients with hepatolithiasis were enrolled in our hospital between March 2008 and March 2017,and all patients underwent laparoscopic partial hepatectomy. During operation,PPV-guided fluid therapy was done in 134 patients. Logistic regression analysis was applied to evaluate the risk factors affecting post-operational complications. Results The intraoperative tidal volume in control was （7.5±1.3） mL/kg,much lower than（8.2±1.4） mL/kg in PPV-guided group （P<0.05）;at the beginning of operation,mean arterial pressure （MAP） and hematocrit in the control were（97.3±15.4） mmHg and （28.6±5.8）%,significantly different compared to（87.4±17.2） mmHg and（34.2±7.4）% in PPV-guided group （P<0.05）;the duration of operation and central venous pressure （CVP） were （414.7±164.8） min and [9.4（5.4,10.2） mmHg,significantly different compared to （321.5±124.7） min and 10.3（6.3,12.8） mmHg in PPV-guided group （P<0.05）;24 hours after operation,the MAP and CVP in PPV-guided group were （81.8±13.5）mmHg and 8.3（6.2,10.1） mmHg,significantly lower than （85.6±14.8） mmHg and 11.4（8.1,14.7） mmHg, respectively, in the control（P<0.05）;the colloid and RBC transfusion in PPV-guided group were （503.5±120.4） mL and0.9（0.6,1.7） units,significantly less than （743.4±243.7） mL and 1.7（0.7,1.9） units in the control （P<0.05）;the post-operational complications occurred in 73 cases,and multivariate analysis showed that the hematocrit and PPV guidance were the independent risk factors affecting the post-operational complication occurrence. Conclusion PPV-guided fluid therapy might improve respiratory function of patients undergoing laparoscopic partial hepatectomy for intrahepatic bile duct stones.

Key words: Hepatolithiasis, Partial hepatectomy, Pulse pressure variation, Fluid therapy