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Intrahepatic stones: the UKM experience
1Department of Surgery, Hospital Universiti Kebangsaan Malaysia, Jalan Tenteram, Cheras, 56000 Kuala Lumpur.
Insights
Intrahepatic stones (stones within the liver) cause significant health problems. Even with advanced surgery, residual stones are common, leading to increased treatment costs and complications.
Area of Science:
- Hepatobiliary Surgery
- Gastroenterology
- Surgical Outcomes
Background:
- Intrahepatic stones are a significant cause of patient morbidity and mortality.
- Effective management of intrahepatic calculi is crucial for improving patient outcomes.
Purpose of the Study:
- To review the management and outcomes of intrahepatic calculi.
- To analyze the incidence and contributing factors of residual stones after treatment.
Main Methods:
- Retrospective analysis of 49 patients with intrahepatic stones treated between January 1993 and June 1996.
- Review of associated biliary diseases, stone locations, and surgical interventions performed.
Main Results:
- 57.1% of patients had residual stones despite surgical and non-surgical interventions.
- Common bile duct exploration was performed in 31 patients, often combined with other procedures.
- Stones were frequently located in both intrahepatic ducts (56%) or the left intrahepatic duct (34%).
Conclusions:
- Residual intrahepatic stones remain a common challenge in hepatobiliary surgery.
- The persistence of stones increases treatment costs and potential complications.
Abstract:
Intrahepatic stones remain a major source of morbidity and mortality. With improving techniques in hepatobiliary surgery, the management and the outcome of intrahepatic calculi is reviewed. Forty-nine cases referred from all over Malaysia between January 1993 to June 1996 were analyzed retrospectively. There were thirty-two females and seventeen males. The median age was 46 years. Biliary diseases encountered in association with intrahepatic calculi included benign strictures (n = 14), ascariasis (n = 3), cholangiocarcinoma (n = 1), Caroli's disease (n = 1), and thalassaemia, (n = 1), fifty-six percent of stones were located in both the intrahepatic ducts while 34% were found in the left intrahepatic duct. Thirty-one patients underwent common bile duct exploration either alone or in combination with liver resection or bilioenteric anastomosis. Despite the various combinations of surgical and non-surgical intervention 28 (57.1%) patients had residual stones. Despite the availability of newer techniques in hepatobiliary surgery, residual stones were common, resulting in higher treatment costs.