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Journal of Gastrointestinal Surgery

, Volume 11, Issue 5, pp 626–630 | Cite as

Reducing Residual and Recurrent Stones by Hepatectomy for Hepatolithiasis

  • Kazuhisa Uchiyama
  • Manabu Kawai
  • Masaki Ueno
  • Satoru Ozawa
  • Masaji Tani
  • Hiroki YamaueEmail author
Article

Abstract

The long-term outcomes of 97 consecutive patients with hepatolithiasis, who underwent treatment from January 1971 to June 2006, were analyzed. The short-term outcomes included the rate of residual stones and complications after treatment, whereas the long-term results included the stone recurrence rate. In 22 of the 97 (22.7%) patients, residual stones were found after treatment for hepatolithiasis. The incidence of residual stones was 0% in hepatectomy patients, 48.6% in cholangioenterostomy patients (p < 0.001, compared with hepatectomy), 25.0% in T-tube drainage patients (p = 0.015, compared with hepatectomy), and 10.0% in percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) patients. In 15 of the 66 (22.7%) patients who were treated for hepatolithiasis, recurrent stones were found after intervals of 5 to 24 years. The incidence of recurrent stones was 13.9% in hepatectomy patients, 28.5% in cholangioenterostomy patients, 25.0% in T-tube drainage patients, and 50.0% in PTCSL patients (p = 0.021, compared with hepatectomy). Hepatectomy appears to be the most effective treatment for selected patients with isolated left hepatolithiasis (L). In PTCSL procedures, favorable results have been obtained when the stones were completely cleared; however, the incidence of recurrent stones is high in patients after PTCSL.

Keywords

Hepatolithiasis Residual stones Recurrent stones Percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) Cholangiocarcinoma 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Kazuhisa Uchiyama
    • 1
  • Manabu Kawai
    • 1
  • Masaki Ueno
    • 1
  • Satoru Ozawa
    • 1
  • Masaji Tani
    • 1
  • Hiroki Yamaue
    • 1
    Email author
  1. 1.Second Department of SurgeryWakayama Medical University School of MedicineWakayamaJapan

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