Surgical management of intrahepatic gallstones

The results of surgical treatment in 100 patients with intrahepatic gallstones are reported including follow-up on 61 patients who survived more than three years. Nine patients died in the follow-up period, and of the remainder, 44 showed complete rehabilitation (72%). The results of follow-up examinations were best shown by improvement in the tests of hepatic function when compared with the values at the time of discharge. However, in those patients with a long duration of illness, or with residual stones or with impairment of liver function, many claimed persistent complaints and showed abnormal late values of hepatic function. Patients with intrahepatic gallstones are best managed: 1) removal of all gallstones as thoroughly as possible, 2) additional procedures to eliminate bile stasis and permit residual stones to enter the intestinal tract and 3) irrigation of the biliary ducts to remove remaining stones.