Treatment of complicated hepatolithiasis with intrahepatic biliary stricture by ductal dilatation and stenting: Long-term results

Yu Fan Cheng, Tze Yu Lee, Shyr Ming Sheen-Chen, Tung Liang Huang, Tai Yi Chen

Research output: Contribution to journalReview article

40 Citations (Scopus)

Abstract

A group of 190 cases of hepatolithiasis with postoperative residual stones located proximal to the stricture sites were managed with the aim of complete clearance of stones and relief of bile stasis to decrease the potential risk of recurrence. All procedures were performed through a T-tube track with gradual dilatation and stent placement through the stricture sites, creating a channel that allows cholangioscopy and electrohydraulic lithotripsy. Complete clearance of intrahepatic duct (IHD) stones was achieved in 88.4% of cases. Multiple sharply angulated IHD strictures in right-sided hepatolithiasis constituted a major cause of failure. Recurrent stone formation and repeated cholangitis, subsequent drainage, and liver resection are associated with high mortality rates particularly if there is late development of a cholangiocarcinoma. We concluded that postoperative ductal dilatation and stenting through the T-tube track combined with endoscopic electrohydraulic lithotripsy is effective and safe for managing complicated hepatolithiasis. Persistent irreversible aneurysmal dilatation of IHD and atrophic change of the affected hepatic lobe at follow-up were ominous signs of recurrence and cholangiocarcinoma development. Early drainage with stone extraction combined with surgical intervention can prevent subsequent morbidity and mortality.

Original languageEnglish
Pages (from-to)712-716
Number of pages5
JournalWorld Journal of Surgery
Volume24
Issue number6
DOIs
Publication statusPublished - Jun 1 2000
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

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