[Intrahepatic calculosis]

After a short synthesis of the elements characterising intrahepatic calculosis, and evaluation of the five cases considered, the value of cholangiography (both intravenous and instrumental) and of radio-scintiscanning with Bengal Rose marked with I131 in pre-operative diagnosis is stressed. The intra-operative use of choledochoscopy in conjunction with cholangiography is recommended. With regard to treatment, it must ensure removal of the calculi and create an ample biliodigestive communication (papillectomy or, even better, hepaticojejunostomy on excluded Roux loop) in order to prevent recurrences. In order to visualise the intrahepatic branches of the bile ducts, the removal of the hilar plaque is advised, possibly combined with sagittal scissurectomy or mobilisation of the 4th segment. In conclusion it is asserted that correctly performed surgical treatment is the only means of offering permanent cure.