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Current management of intrahepatic stones

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Abstract

A high incidence of intrahepatic stones occurs in East Asia. The surgical management of intrahepatic stones is problematic because it is difficult to locate and remove all the stones and relieve the accompanying biliary strictures. Consequently, the rate of recurrent cholangitis is high. Many new techniques have been introduced to locate, fragment, and retrieve gallstones. Operative procedures to relieve biliary strictures have also undergone development. These new procedures and techniques have been applied to intrahepatic stones. The initial results are good. Whether these good results can be maintained in the long-term remains to be seen.

Résumé

La lithiase intrahépatique est fréquente en Asie de l'Est. Le traitement chirurgical des calculs intrahépatiques pose des problèmes car il est difficile de localiser les calculs, de tous les enlever et de pallier la sténose concomitante des voies biliares. Ainsi le taux de récidive d'angiocholite est fort. On a trouvé de nombreuses techniques nouvelles pour localiser, fractionner et extraire les calculs biliaires ainsi que des procédés efficaces pour traiter la sténose des voies biliaires. On a appliqué ces techniques et procédés nouveaux aux calculs intrahépatiques. Les premiers résultats sont bons. Reste à voir si ces bons résultats resteront valables à long terme.

Resumen

En el Asia Oriental se presenta una elevada incidencia de cálculos intrahepáticos. El manejo quirúrgico de los cálculos intrahepáticos es problemático por cuanto es difícil localizar y extraer la totalidad de los cálculos y corregir las estrecheces biliares asociadas. En consecuencia, es alta la tasa de colangitis recurrente. Se han descrito numerosa nuevas técnicas para localizar, fragmentar, y extraer los cálculos. También han tenido novedoso desarrollo los procedimientos operatorios para corregir las estenosis biliares. Tales procedimientos y técnicas innovativas han sido aplicados al tratamiento de los cálculos intrahepáticos. Los resultados iniciales son buenos, pero habrá que ver si tales buenos resultados persisten en el seguimiento a largo plazo.

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Authors and Affiliations

  1. Department of Surgery, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong

    T. K. Choi M.D., F.A.C.S. & J. Wong Ph.D., F.R.C.S.E., F.R.A.C.S., F.R.C.S.

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  1. T. K. Choi M.D., F.A.C.S.
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  2. J. Wong Ph.D., F.R.C.S.E., F.R.A.C.S., F.R.C.S.
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Choi, T.K., Wong, J. Current management of intrahepatic stones. World J. Surg. 14, 487–491 (1990). https://doi.org/10.1007/BF01658673

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