Current management of intrahepatic stones

Abstract

A high incidence of intrahepatic stones occurs in East Asia. The surgical management of intrahepatic stones is problematic because it is difficult to locate and remove all the stones and relieve the accompanying biliary strictures. Consequently, the rate of recurrent cholangitis is high. Many new techniques have been introduced to locate, fragment, and retrieve gallstones. Operative procedures to relieve biliary strictures have also undergone development. These new procedures and techniques have been applied to intrahepatic stones. The initial results are good. Whether these good results can be maintained in the long-term remains to be seen.

Pyogenic liver abscess: Retrospective analysis of 80 cases over a 10‐year period

“…This is probably explained by the high incidence of recurrent pyogenic cholangitis in this series . 18 The low pus culture positivity rate (44/80, 55%) was probably related to the use of empirical antibiotics treatment prior to the drainage procedure.…”

Left-sided hepatic resection for hepatolithiasis: a longitudinal study of 110 patients

“…In hepatolithiasis, the goal of treatment is to provide complete stone clearance, decompression of the biliary tree and control of infection; thus the management has to be individualized according to different presentation of the disease. Treatment options include surgical treatment with biliary decompression and/or hepatic resection as the first approach 14,15 . Non‐surgical procedures such as percutaneous transhepatic lithotriphy or endoscopic therapy are usually reserved to treat stone recurrences 16,17 .…”

“…Treatment options include surgical treatment with biliary decompression and/or hepatic resection as the first approach. 14,15 Non-surgical procedures such as percutaneous transhepatic lithotriphy or endoscopic therapy are usually reserved to treat stone recurrences. 16,17 Morbidity and mortality rates for hepatic resection have decreased significantly in the last decade.…”

Recurrent Pyogenic Cholangitis Treated by Left Hepatectomy

“…The therapeutic goals for the management of recurrent pyogenic cholangitis should include the complete clearance of calculi and particulate debris from the biliary tract and the elimination of bile stasis to prevent recurrent stone formation [12][13][14][15]. It requires multidisciplinary approach, integrating interventional radiology, interventional endoscopy and surgery.…”