BACKGROUND/AIMS: The aim of this study is to explore the surgical treatment for hepatolithiasis. METHODOLOGY: Data of 1431 consecutive patients who underwent surgical treatment from January 2000 to December 2006 in West China Hospital were collected retrospectively and analyzed. Surgical procedures included T-tube insertion combined intraoperative cholangioscopic removal of intrahepatic stones, hepatectomy, cholangiojejunostomy and liver transplantation. RESULTS: 1384 patients were performed T-tube insertion combined intraoperative and postoperative cholangioscopic removal of intrahepatic stones and the rate of residual stone was 11.5%. 370 patients were performed hepatectomy and the rate of residual stone was 2.7%. 23 patients were performed cholangiojejunostomy and the rate of residual stone was 26.1%. 15 patients of hepatolithiasis were performed liver transplantation, and they had survived from liver transplantation. CONCLUSIONS: T-tube insertion combined intraoperative cholangioscopic removal of intrahepatic stones and cholangioscopic lithotripsy should be considered for patients of hepatolithiasis above all. Hepatic resection is optimal for patients with liver atrophy, liver abscess and biliary stricture. However, liver transplantation is a possible method for end-stage hepatolithiasis.
BACKGROUND/AIMS: The aim of this study is to explore the surgical treatment for hepatolithiasis. METHODOLOGY: Data of 1431 consecutive patients who underwent surgical treatment from January 2000 to December 2006 in West China Hospital were collected retrospectively and analyzed. Surgical procedures included T-tube insertion combined intraoperative cholangioscopic removal of intrahepatic stones, hepatectomy, cholangiojejunostomy and liver transplantation. RESULTS: 1384 patients were performed T-tube insertion combined intraoperative and postoperative cholangioscopic removal of intrahepatic stones and the rate of residual stone was 11.5%. 370 patients were performed hepatectomy and the rate of residual stone was 2.7%. 23 patients were performed cholangiojejunostomy and the rate of residual stone was 26.1%. 15 patients of hepatolithiasis were performed liver transplantation, and they had survived from liver transplantation. CONCLUSIONS: T-tube insertion combined intraoperative cholangioscopic removal of intrahepatic stones and cholangioscopic lithotripsy should be considered for patients of hepatolithiasis above all. Hepatic resection is optimal for patients with liver atrophy, liver abscess and biliary stricture. However, liver transplantation is a possible method for end-stage hepatolithiasis.