Significance of Controlling Chronic Proliferative Cholangitis in the Treatment of Hepatolithiasis

Abstract

Overall, the subsequent treatment of residual CPC after operation or choledochoscopic lithotomy would be helpful to decrease postoperative stone recurrence and the rate of biliary restenosis. Adding such treatment would reduce the incidence of surgical reintervention and choledochoscopic lithotomy, and it would also improve the postoperative hepatolithiasis outlook.

Four Major Factors Contributing to Intrahepatic Stones

“…In addition, bacterial lipopolysaccharide (LPS) increases mucin 5AC (MUC5AC) by tumor necrosis factor- α converting enzyme (TACE)/transforming growth factor- α (TGF- α )/growth factor receptor (EGFR) pathway in intrahepatic biliary epithelial cells also involved in the formulation and development of intrahepatic stone [5]. Meanwhile, bacterial infection will aggravate cholestasis and cholangitic stenosis to form a vicious circle, continuously stimulating the formation and growth of stones [6]. Lately, Helicobacter pylori ( H. pylori ) has been found to be related with the occurrence of intrahepatic stone as well [7].…”

Choledochoscopic high‐frequency needle‐knife electrotomy as an effective treatment for intrahepatic biliary strictures

“…A vicious cycle exists between the presence of intrahepatic calculi and chronic proliferative cholangitis . In the later stages of inflammation, a stricture of the duct may occur when inflammation and fibrosis are localized within a short segment of the duct .…”

“…23 A vicious cycle exists between the presence of intrahepatic calculi and chronic proliferative cholangitis. 24 In the later stages of inflammation, a stricture of the duct may occur when inflammation and fibrosis are localized within a short segment of the duct. 25 An increase in connective tissues causes the wall of the duct to thicken and to show signs of fibrosis, proliferation of mucous and serous glands, and inflammatory cell infiltration at the wall and the periductal tissue.…”

Chemical bile duct embolization for chemical hepatectomy, long term efficacy and feasibility in rats

“…Repeated episodes of CPC leads to stone formation, thus forming a vicious cycle of CPC and stone formation. 2,19 Therefore, treatment of hepatolithiasis must include clearance of stones, correction of biliary stricture and elimination of CPC. Presently, traditional hepatectomy remains the only treatment of choice for hepatolithiasis.…”

“…The degree of biliary stricture is directly proportional to the frequency of stone recurrence. 2 This is further associated with gradual worsening of the…”