Surgical therapy for hepatolithiasis: a Western experience

Area of Science:

• Hepatobiliary surgery
• Gastroenterology
• Surgical oncology

Background:

• Hepatolithiasis, or bile duct stones, is prevalent in East Asia but rare in Western countries.
• The association between hepatolithiasis and cholangiocarcinoma is established in East Asia but less so in Europe and the US.
• Limited European data exists on the outcomes of surgical hepatolithiasis treatment.

Purpose of the Study:

• To evaluate the perioperative and long-term outcomes of surgical interventions for hepatolithiasis.
• To assess the safety and efficacy of surgical management for this condition.
• To investigate the risk of cholangiocarcinoma in patients with hepatolithiasis.

Main Methods:

• Retrospective review of 22 patients who underwent surgical treatment for hepatolithiasis.
• Analysis of immediate outcomes including operative morbidity and mortality.
• Assessment of long-term results such as stone recurrence and patient survival.

Main Results:

• No operative mortality was observed.
• The overall morbidity rate was 27.3%, with right hepatectomy identified as a predictor of postoperative complications.
• One patient (4.5%) had an undiagnosed cholangiocarcinoma at surgery. No recurrent cholangitis occurred during a mean follow-up of 67.59 months.

Conclusions:

• Surgical therapy provides a safe and effective approach for managing hepatolithiasis.
• Hepatic resection is crucial for eliminating the risk of cholangiocarcinoma in patients with chronic hepatolithiasis.
• Long-term follow-up demonstrated no recurrent cholangitis after surgical treatment.