Choice of treatment for hepatolithiasis based on pathological findings

Abstract

Abstract The results of surgical treatment in 56 patients with hepatolithiasis are reported including a follow‐up study on 53 patients who survived more than 1 year (median, 5 years and 8 months). Patients were treated by 4 different procedures, i.e., common duct exploration in 32 patients, hepatic resection in 13 patients, hepatic resection with intrahepatic cholangiojejunostomy in 6 patients, and endoscopic stone removal in 5 patients. These procedures were combined with additional procedures, i.e., sphincteroplasty and bilioenteric anastomosis when necessary. There were no operative deaths. The stones were completely removed in 51.8% of the patients. Follow‐up study for 1 to 10 years showed good results in 70.8% of the patients. Residual stones were often observed in the cases with stricture at the liver hilum and this led to poor results at follow‐up. The results of various procedures were evaluated in relation to the prevailing pathology such as bile duct stricture and the location of stones .