Surgical management of hepatolithiasis: A minireview

Li, Chuan; Wen, Tianfu

doi:10.5582/irdr.2017.01027

Cited by 29 publications

(14 citation statements)

References 31 publications

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“…It should be kept in mind that the risk of ICCA is higher in patients with biliary stricture, liver atrophy, high levels of CA 19-9, in cases of HL especially located on the left side, in the presence of microabscess and in patients with choledochoenterostomies (4,13,21,27). The risk of tumor increases in bilateral HL cases (28,29).…”

Section: Discussionmentioning

confidence: 99%

Hepatolithiasis: clinical series, review and current management strategy

et al. 2020

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Objective: Hepatolithiasis (HL) continues to be a problem due to its local and systemic complications, insufficiency in treatment modalities and high risk of recurrence. There are various surgical options available, ranging from endoscopic interventions to a small segment resection and ultimately to transplantation. In this article, patients with the diagnosis of HL and our treatment strategies were evaluated in the light of literature. Material and Methods:The patients diagnosed with HL in our clinic between 2014-2019 were evaluated retrospectively by examining the patient files. Demographic characteristics of the patients, causes of the disease, complications and treatment options were evaluated.Results: 17 patients were included into the study. Mean age of the patients was 64.3 years (range 32-89 years). Seven patients had previous cholecystectomies. Stenosis was found to be developed in hepaticojejunostomy (HJ) site in three patients (two had HJ due to bile duct injury and one had HJ following the Whipple procedure), and in hepaticoduodenostomy site in one patient who had the history of biliary tract injury during cholecystectomy. Two patients with HL without previous cholecystectomies had no gallbladder stones. Nine patients underwent surgery. Left hepatectomy was performed in two patients and lateral sector resection was performed in 2 patients. Two patients with anastomotic stenosis underwent HJ revision and two patients with anastomotic stenosis and one patient with stent ingrowth underwent bifurcation resection and neo-hepaticojejunostomy. Eight patients were followedup nonoperatively with medical and endoscopic approaches. Conclusion:Hepatolithiasis is a serious condition that needs to be treated with a multimodal approach. Stenting and anastomotic stenosis facilitate the development of hepatolithiasis and increase the risk of its occurrence. In particular, by performing functional hepaticojejunostomy, the development of this complication will be decreased.

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Section: Discussionmentioning

confidence: 99%

Hepatolithiasis: clinical series, review and current management strategy

et al. 2020

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“…Hepatolithiasis is the presence of intra-hepatic bile duct lithiasis [1]. It is prevalent in East Asia but its prevalence is increasing in the Western countries because of immigration (0.6%-1.3%) [2,3]. Hepatolithiasis is known as the main cause of recurrent pyogenic cholangitis.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Hepatolithiasis as a Cause of Recurrent Cholangitis

Carmen

MeleroAlba

et al. 2017

Surgical Infections Case Reports

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Background: Hepatolithiasis is the presence of calculi in the intra-hepatic bile ducts. If left untreated, it may cause recurrent cholangitis, hepatic abscesses, cirrhosis, liver atrophy, or degeneration to cholangiocarcinoma. Morbidity increases in bilateral forms of presentation. It is thought that a transitory bactibilia stimulates the formation of lithiasis. This leads to a persistent bactibilia, and therefore increases the risk of cholangitis. The most commonly found micro-organisms in bile cultures are Escherichia coli, Klebsiella, Pseudomonas, and Proteus. Case Presentation: We present the case of a 67-year-old male with a finding of portal hypertension and bilateral hepatolithiasis discovered while studying a dissociated cholestasis. After several unsuccessful attempts for complete extraction of hepatolithiasis through conservative means (transparietohepatic approach, endoscopic retrograde cholangiopancreatography with endoscopic laser therapy) and because of recurrent episodes of cholangitis, a simultaneous surgical and endoscopic approach was undertaken (cholecystectomy with bile duct exploration and intra-operative laser therapy). The patient currently remains asymptomatic. Conclusion: The treatment of hepatolithiasis has evolved because of the increase in the number of non-surgical techniques such as endoscopic laser therapy. Currently a surgical approach implying cholecystectomy and bile duct exploration combined with endoscopic laser techniques could be the elective treatment option, allowing the prevention of hepatectomy especially in patients at elevated surgical risk and in bilateral cases of hepatolithiasis.

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“…The goal of hepatolithiasis treatment is to resolve ongoing infections, prevent recurrent cholangitis and subsequent hepatic fibrosis, avoid multiple instrumentations and minimize the potential of progression to cholangiocarcinoma. 5 Despite that conservative management options have been well described and established in the literature; surgery remains the standard of care for the definitive treatment of the disease. 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.…”

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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Surgical management of hepatolithiasis: A minireview

Cited by 29 publications

References 31 publications

Hepatolithiasis: clinical series, review and current management strategy

Hepatolithiasis: clinical series, review and current management strategy

Hepatolithiasis as a Cause of Recurrent Cholangitis

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

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