C Marín1, R Robles, P Pastor, P Parrilla. 1. Departamento de Cirugía, Unidad de Cirugía Hepática y Transplante Hepática, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia. rirocam@um.es
Abstract
OBJECTIVE: intrahepatic lithiasis (IHL) is an uncommon entity in our environment. When associated with Caroli s disease or stenosis of the biliary radicals it may be necessary to perform liver resection to provide definitive resolution. We present immediate and long term results in a Spanish series of patients with hepatic resection to treat hepatolithiasis. PATIENTS: between January 1996 and December 2007 we performed a liver resection (LR) in 8 patients for IHL. The IHL was associated with Caroli s disease in 3 cases and with stenosis of segmentary radicals in the other 5 cases. It manifested itself as acute cholangitis in 5 cases, as biliary colic in two cases and recurrent pancreatitis in one case. The surgical technique was 1 right hepatectomy, 2 left hepatectomies and 5 segmentary resections. RESULTS: there was no intra- or postoperative mortality. The morbidity rate was 25%. One patient (12%) with Caroli s disease which had malignised to cholangiocarcinoma died in the follow-up period. The remaining 7 patients have had no IHL recurrence after a mean follow-up of 62 +/- 2 months (range: 31-106). CONCLUSIONS: in our experience liver resection, either lobar or segmentary, is the treatment for patients with IHL associated with stenosis and dilatation of the bile duct, as it provides complete resolution of the disease with low rates of morbidity and mortality.
OBJECTIVE:intrahepatic lithiasis (IHL) is an uncommon entity in our environment. When associated with Caroli s disease or stenosis of the biliary radicals it may be necessary to perform liver resection to provide definitive resolution. We present immediate and long term results in a Spanish series of patients with hepatic resection to treat hepatolithiasis. PATIENTS: between January 1996 and December 2007 we performed a liver resection (LR) in 8 patients for IHL. The IHL was associated with Caroli s disease in 3 cases and with stenosis of segmentary radicals in the other 5 cases. It manifested itself as acute cholangitis in 5 cases, as biliary colic in two cases and recurrent pancreatitis in one case. The surgical technique was 1 right hepatectomy, 2 left hepatectomies and 5 segmentary resections. RESULTS: there was no intra- or postoperative mortality. The morbidity rate was 25%. One patient (12%) with Caroli s disease which had malignised to cholangiocarcinoma died in the follow-up period. The remaining 7 patients have had no IHL recurrence after a mean follow-up of 62 +/- 2 months (range: 31-106). CONCLUSIONS: in our experience liver resection, either lobar or segmentary, is the treatment for patients with IHL associated with stenosis and dilatation of the bile duct, as it provides complete resolution of the disease with low rates of morbidity and mortality.