The surgical treatment of isolated left-sided hepatolithiasis: A 22-year experience

Indication and Procedure for Treatment of Hepatolithiasis

“…9 The incidence of residual stones has markedly decreased from 19.8% to 62.3% 3,10 without cholangioscopy to 10.0% to 30.2% with intraoperative and postoperative cholangioscopy. [1][2][3][4][5][6][7][8][9][10] In our study, the residual stone rate after PTCSL for hepatolithiasis is 14.3%. Cholangiojejunostomy was one of the major treatment procedures for hepatolithiasis before 1985, but the rate of residual stones was 56% (14/25) after this treatment.…”

Intraoperative biliary exploration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis

“…Left hepatectomy for LIHS can be a definitive treatment, as the surgical risk is acceptably low and it removes all causative lesions [1,4,5]. In this study, although follow-up period was not long enough and dropout rate was not negligible, there was only one asymptomatic recurrence in 44 LIHS patients.…”

“…Fifty patients underwent left hepatectomy due to LIHS or bilateral intrahepatic stone (BIHS) and were followed-up until March 2007. Left lateral segmentectomy has been rarely carried out in our institution due to the high recurrence rate [1] and was excluded from this series (n=2). Patients who had previously undergone choledochoduodenostomy (n=1) or choledochojejunostomy (n=1) were also excluded to simplify the study design.…”

“…However, it is routinely performed to explore the common bile duct (CBD) and right hepatic duct for removal of the residual stones or for identification and relief of stenoses in the remnant liver side. While bile duct exploration through choledochotomy and subsequent T-tube insertion has been commonly performed for such purposes [1], this approach often resulted in surgical complications or discomfort, especially related to the T-tube.…”

“…Primary hepatolithiasis shows diverse features in terms of pathogenesis, clinical manifestation, and treatment [1][2][3][4][5][6]. While a common disease in East Asia [7][8][9], it is rare in other areas of the world [10].…”