A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort

Suzuki, Yutaka; Mori, Toshiyuki; Yokoyama, Masaaki; Kim, Sang‐Chul; Momose, Hirokazu; Matsuki, Ryota; Kogure, Masaharu; Abe, Nobutsugu; Isayama, Hiroyuki; Nakazawa, Takahiro; Notohara, Kenji; Tanaka, Atsushi; Tsuyuguchi, Toshio; Tazuma, Susumu; Takikawa, Hajime; Sugiyama, Masanori

doi:10.1007/s00535-017-1410-6

Cited by 13 publications

(9 citation statements)

References 15 publications

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“…Several studies have previously reported old age, bile duct stenosis, bilioenteric anastomosis, stone recurrence, stones in both hepatic lobes, and no liver resection as risk factors for subsequent cholangiocarcinoma after treatment (Li et al, 2012;Suzuki et al, 2012;Kim et al, 2015b;Suzuki et al, 2018). In the present study, liver atrophy and precancerous lesions, which have not been evaluated in previous studies, were significant risk factors for subsequent cholangiocarcinoma after treatment for hepatolithiasis.…”

Section: Discussionsupporting

confidence: 39%

“…In the present study, 3 of the 62 patients (4.8%) died of secondary biliary cirrhosis due to repeated cholangitis after liver resection for hepatolithiasis. Chronic cholestasis, repeated cholangitis, and bile duct stricture lead to biliary cirrhosis (Suzuki et al, 2018). In fact, all three patients in the present study had repeated cholangitis due to residual stones and residual bile duct stricture.…”

Section: Discussionmentioning

confidence: 48%

“…The development of cholangiocarcinoma in patients with hepatolithiasis is a critical issue. Although the observation period has varied among the studies published to date, the reported incidence rates of subsequent cholangiocarcinoma after any treatments are 4.8% (11/227 patients) (Cheon et al, 2009), 6.8% (16/236 patients) (Kim et al, 2015b), and 6.9% (27/392 patients) (Suzuki et al, 2018). Furthermore, the reported incidence rates of subsequent cholangiocarcinoma after liver resection are 4% (3/77 patients during a median 8-year follow-up period) (Cheon et al, 2009), and 6.3% (6/95 patients during a median 41-month follow-up period) (Kim et al, 2015b).…”

Section: Discussionmentioning

confidence: 99%

“…Although risk factors for hepatolithiasis-related death and subsequent cholangiocarcinoma after liver resection for hepatolithiasis were reported by a few studies (Kim et al, 2015b;Suzuki et al, 2018), precancerous lesions such as BilIN and IPNB have not been evaluated. In the present study, we investigated risk factors, including precancerous lesions, for hepatolithiasis-related death and subsequent cholangiocarcinoma after liver resection for hepatolithiasis.…”

Section: Precancerous Lesions and Liver Atrophy As Risk Factors For Hmentioning

confidence: 99%

“…Albeit a benign disease, hepatolithiasis can lead to cholangiocarcinoma and secondary biliary cirrhosis due to repeated cholangitis and stones (Kubo et al, 1995;Kim et al, 2015a;Suzuki et al, 2018). Therefore, complete removal of hepatolithiasis and elimination of bile stasis due to bile duct strictures are necessary for the prevention of repeated cholangitis and stone recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Precancerous Lesions and Liver Atrophy as Risk Factors for Hepatolithiasis-Related Death after Liver Resection for Hepatolithiasis

Miyazaki

Shinkawa

Takemura

et al. 2020

Asian Pac J Cancer Prev

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Background: Cholangiocarcinoma and secondary biliary cirrhosis can develop after liver resection for hepatolithiasis and are causes of hepatolithiasis-related death. We determined potential risk factors for hepatolithiasis-related death and subsequent cholangiocarcinoma, including precancerous lesions such as biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile duct, in patients undergoing liver resection for hepatolithiasis. Methods: The study cohort included 62 patients who underwent liver resection for hepatolithiasis without concomitant cholangiocarcinoma and had surgical specimens available for pathological examination. Univariate and multivariate analyses were conducted to examine risk factors associated with subsequent cholangiocarcinoma after hepatolithiasis and hepatolithiasis-related death. In 28 patients with BilIN lesions, the specimens were immunohistochemically stained for γ-H2AX and S100P. Results: In the study cohort, the causes of death were subsequent cholangiocarcinoma, biliary cirrhosis, and other diseases in 5, 3, and 7 patients, respectively. Liver atrophy, precancerous lesions, postoperative repeated cholangitis, and jaundice for ≥1 week during the follow-up period were risk factors for hepatolithiasis-related death. Multivariate analysis showed that liver atrophy and precancerous lesions were independent risk factors for hepatolithiasis-related death. Liver atrophy or precancerous lesions were also risk factors for subsequent cholangiocarcinoma by univariate analysis. The positive expression of γ-H2AX and S100P was observed in 18 and 14 of the 28 BilIN lesions, respectively. Conclusions: Liver atrophy and precancerous lesions with malignant transformation were risk factors not only for subsequent cholangiocarcinoma but also hepatolithiasis-related death after liver resection for hepatolithiasis, indicating that long-term follow-up is necessary even after liver resection in patients harboring these risk factors.

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Section: Discussionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Precancerous Lesions and Liver Atrophy As Risk Factors For Hmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Precancerous Lesions and Liver Atrophy as Risk Factors for Hepatolithiasis-Related Death after Liver Resection for Hepatolithiasis

Miyazaki

Shinkawa

Takemura

et al. 2020

Asian Pac J Cancer Prev

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Assessing outcomes and complications of secondary hepatolithiasis after choledochoenterostomy: A nationwide survey in Japan

Suzuki,

Yoshida,

Fujisawa

et al. 2024

J Hepato Biliary Pancreat

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BackgroundThis study aimed to evaluate the outcomes and complications of secondary hepatolithiasis following choledochoenterostomy to guide suitable management.MethodsThe study analyzed 127 patients from a 2017 national survey conducted by the Ministry of Health, Labor, and Welfare. The 2023 cohort study assessed residual stones, recurrences, cholangitis, cholangiocarcinoma, and prognosis.ResultsThe median follow‐up duration was 48 months. Balloon endoscopy‐assisted endoscopic retrograde cholangiography (BE‐ERC) was the most common treatment, achieving complete stone clearance in 84.4% of patients. Anatomical hepatectomy was the most common surgery. Predictors of residual stones were stone number ≥10 (odds ratio [OR], 7.480; p = .028) and stone diameter ≥10 mm (OR, 5.280; p = .020). Predictors of stone recurrence during follow‐up were biliary strictures (hazard ratio [HR], 3.580; p = .005) and cholangitis (HR, 2.700; p = .037). Predictors of cholangitis during follow‐up were biliary stricture (HR, 5.016; p = .006) and dilatation (HR, 3.560; p = .029). Any treatment for hepatolithiasis reduced cholangitis occurrence (HR, 0.168; p = .042). Balloon dilation combined with stenting for ≥3 months improved biliary strictures in 57.1% of patients.ConclusionThis study recommends BE‐ERC as the first‐choice treatment for secondary hepatolithiasis. Stone removal and relief of biliary strictures and dilatation are crucial to prevent stone recurrence and cholangitis after treatment.

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Classification of left-side hepatolithiasis for laparoscopic middle hepatic vein-guided anatomical hemihepatectomy combined with transhepatic duct lithotomy

et al. 2023

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A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort

Abstract: The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes.

Cited by 13 publications

References 15 publications

Precancerous Lesions and Liver Atrophy as Risk Factors for Hepatolithiasis-Related Death after Liver Resection for Hepatolithiasis

Precancerous Lesions and Liver Atrophy as Risk Factors for Hepatolithiasis-Related Death after Liver Resection for Hepatolithiasis

Assessing outcomes and complications of secondary hepatolithiasis after choledochoenterostomy: A nationwide survey in Japan

Classification of left-side hepatolithiasis for laparoscopic middle hepatic vein-guided anatomical hemihepatectomy combined with transhepatic duct lithotomy

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