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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
Evolution of surgical treatment for hepatolithiasis
Yong-Qing Ye1, Pei-Heng Li2, Qing Wu1
1Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China.
Insights
Hepatolithiasis, or intrahepatic bile duct stones, presents treatment challenges with high recurrence rates. This review examines surgical options like hepatectomy and liver transplantation for effective management.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Surgical Oncology
Background:
- Hepatolithiasis involves stones in the intrahepatic bile duct, a condition with regional prevalence and high complication/recurrence rates.
- Primary mortality causes include intrahepatic cholangiocarcinoma and liver cirrhosis, complicating treatment.
- While endoscopic removal is common for biliary stones, complex cases necessitate surgical or percutaneous interventions.
Purpose of the Study:
- To review current mainstream surgical treatment modalities for hepatolithiasis.
- To provide clinicians with a reference for selecting optimal surgical approaches.
- To discuss advancements in hepatolithiasis treatment.
Main Methods:
- Review of established surgical techniques for hepatolithiasis.
- Inclusion of methods such as partial hepatectomy, choledochojejunostomy, biliary tract exploration and lithotomy.
- Consideration of percutaneous transhepatic choledochoscopic lithotripsy and liver transplantation.
Main Results:
- Hepatolithiasis treatment is challenging due to disease complexity and high recurrence rates.
- Surgical intervention remains the primary clinical approach for hepatolithiasis.
- Advancements in medical technology are improving treatment outcomes.
Conclusions:
- The choice of surgical method for hepatolithiasis depends on individual patient characteristics.
- Selecting the appropriate surgical strategy is crucial for achieving the best treatment outcomes.
- Continuous development in surgical techniques offers improved management for hepatolithiasis patients.
Abstract:
Hepatolithiasis is a common disease where stones are located in the intrahepatic bile duct. Hepatolithiasis is a disease with regional characteristics. The complication and postoperative recurrence rates of the disease are high. The intrahepatic cholangiocarcinoma and the incidence of liver cirrhosisare the main causes of death in patients with hepatolithiasis. Thus, it is difficult to treat. The majority of biliary stones are readily removed endoscopically, however complex intrahepatic or large refractory extrahepatic stones often require surgical or percutaneous interventions when standard endoscopic methods fail. At present, the main clinical treatment for hepatolithiasis is surgery, of which there are different methods depending on the patient's condition. With the continuous updates and development of medical technology, the treatment of hepatolithiasis has improved. In this paper, several mainstream surgical methods including partial hepatectomy, choledochojejunostomy, biliary tract exploration and lithotomy, percutaneous transhepatic chledochoscopic lithotripsy and liver transplantation used in the clinic are reviewed for clinicians' reference. Depending on the characteristics of each case, a suitable surgical method is chosen to obtain the best treatment effect.
