Management of Hepatolithiasis: Review of the Literature

Lorio, Eric; Patel, Pavan; Rosenkranz, Laura; Patel, Sandeep; Sayana, Hari

doi:10.1007/s11894-020-00765-3

Cited by 46 publications

(41 citation statements)

References 72 publications

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“…Another risk is development of cholangiocellular carcinoma (2,4). The incidence of hepatolithiasis in the indigenous people of the Western countries remains very low; therefore, this diagnosis is not immediately considered in patients with biliary symptoms (5). Clinical symptomatology depends mainly on the severity and location of biliary tract obstruction (1,6).…”

Section: Discussionmentioning

confidence: 99%

“…The biggest challenge, therefore, remains the adequate and effective treatment that allows for restoration of bile drainage by removing the bile stones or strictures and, if the parenchyma is damaged, its resection (3). Choice of treatment depends on the extent of hepatolithiasis (5,8). Liver resection is considered as the optimal treatment because it removes damaged bile ducts and parenchyma, thereby minimizing the risk of recurrence of hepatolithiasis and cholangiocellular carcinoma formation (3,9).…”

Section: Discussionmentioning

confidence: 99%

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The Difficult Path to Correct Diagnosis of Hepatolithiasis: A Case Report

Mikolajcik

Ferko

Demeter

et al. 2021

Acta Med. (Hradec Kralove, Czech Repub.)

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Hepatolithiasis is a benign disease, where stones are localized proximal to the confluence of hepatic ducts. The clinical picture may differ depending on whether the stones cause complete, partial, or intermittent biliary obstruction. The course can vary from asymptomatic to fatal, thus, early diagnosis and treatment is critical for a good prognosis. The gold standard in imaging is magnetic resonance cholangiopancreatography (MRCP). However, correct diagnosis can be challenging due to atypical clinical picture and laboratory findings. We present a case where hepatolithiasis was misdiagnosed initially due to incomplete reporting and documentation of MRCP. Choledocholithiasis was diagnosed based on initial MRCP, and endoscopic stone extraction was indicated. However, an unusual post-interventional course and signs of obstructive cholangitis led to an endoscopic re-intervention, which confirmed absence of pathology in extrahepatic biliary ducts. The cholangitis recurrence required intensive antibiotic treatment, and CT examination revealed intrahepatic S3 bile duct dilatation. Thus, a re-evaluation of initial MRCP and repeated MRCP confirmed hepatolithiasis. Further, laparoscopic bisegmentectomy was chosen as the definitive treatment due to the location of the lesion. The patient recovered and remained symptom free upon a 12 month follow up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Difficult Path to Correct Diagnosis of Hepatolithiasis: A Case Report

Mikolajcik

Ferko

Demeter

et al. 2021

Acta Med. (Hradec Kralove, Czech Repub.)

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“…Particularly, sectional hepatectomy is considered as the best approach for the treatment of calculi of the intrahepatic ducts, since it removes stones, along with the strictured intrahepatic duct, resects the atrophic portion of the liver and, additionally, eliminates the potential of cholangiocarcinoma development. 6,7 In current study, we sought to present the recent experience regarding the surgical management of recurrent, symptomatic left hepatolithiasis in the background of a narrative literature review.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of hepatolithiasis: an institutional experience of a rare disease

et al. 2021

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Hepatolithiasis remains as a rare condition in the majority of western world countries. Although genetic, dietary and environmental factors have been associated with the disease, the exact etiology of this entity remains elusive. Several approaches; surgical and non-invasive have been well described. However, surgery remains the standard of care for definitive treatment of the disease. We sought to present the recent experience of our clinic regarding the surgical management of hepatolithiasis in the backgound of a narrative literature review. All adult patients with hepatolithiasis admitted to our center during the period 2018 to 2020 were included in the study. Patients’ demographics, comorbidities and preoperative characteristics were collected by chart review. All patients underwent open left lateral hepatectomy. Three cases with hepatolithiasis were identified. All of them were male and had been suffering from recurrent pyogenic cholangitis. All patients remained asymptomatic and disease-free through the entire follow-up, except one case that was complicated with bile leakage during the immediate postoperative period. Hepatolithiasis is currently a rare condition in the western world. Surgery is safe and effective treatment approach for refractory cases and, provided that it is performed by experts in hepatobiliary surgery, it remains imperative for the definitive treatment of the disease.

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“…Hepatolithiasis commonly occurs in the bile duct proximal to the confluence of the right and left hepatic ducts, regardless of the coexistence of gallstones in gallbladder or the common bile duct. [ 1 – 3 ] The incidence rate is 3.1% to 21.2%, mostly in Asia-Pacific region, such as China, Japan, and Korea. [ 4 ] The obstruction caused by stone could lead to bile duct inflammation, stenosis, and liver fibrosis, and it may even further cause liver atrophy or malignant transformation to lead to serious complications of biliary tract and the whole system, which is the common cause of death in nonmalignant diseases of biliary tract.…”

Section: Introductionmentioning

confidence: 99%

“…At present, the principal treatment for hepatolithiasis is hepatectomy, [ 3 ] which could not only resect the lesion, but also could treat and prevent the complications of hepatolithiasis in the middle and late stages. Conventionally, open hepatectomy is frequently applied in the treatment of hepatolithiasis.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and advantages of minimally invasive hepatectomy for hepatolithiasis

Jianyang

Xu²,

Luo

et al. 2020

Medicine

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Background: Hepatolithiasis commonly occurs in the bile duct proximal to the confluence of the right and left hepatic ducts, regardless of the coexistence of gallstones in gallbladder or the common bile duct. Clinical research proves that minimally invasive surgery is effective in the treatment of hepatolithiasis. Although previous meta-analysis also shows that it could reduce intraoperative bleeding and blood transfusion, and shorten hospital stay time, there are few meta-analyses on its long-term efficacy. We conducted the meta-analysis and systematic review to systematically evaluate the long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis. Methods: Articles of randomized controlled trials will be searched in the PubMed, Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, Chinese Biological and Medical database, and Wanfang database until September, 2020. Literature extraction and risk of bias assessment will be completed by 2 reviewers independently. Statistical analysis will be conducted in RevMan 5.3. Results: This study will summarize the present evidence by exploring the long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis Conclusions: The findings of the study will help to determine potential long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis. Ethics and dissemination: The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF Registration number: DOI 10.17605/OSF.IO/H6WRV.

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Management of Hepatolithiasis: Review of the Literature

Cited by 46 publications

References 72 publications

The Difficult Path to Correct Diagnosis of Hepatolithiasis: A Case Report

The Difficult Path to Correct Diagnosis of Hepatolithiasis: A Case Report

Surgical management of hepatolithiasis: an institutional experience of a rare disease

Long-term efficacy and advantages of minimally invasive hepatectomy for hepatolithiasis

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