Evolution of surgical treatment for hepatolithiasis.

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY World Journal of Gastrointestinal Surgery Pub Date : 2024-12-27 DOI:10.4240/wjgs.v16.i12.3666
Yong-Qing Ye, Pei-Heng Li, Qing Wu, Shang-Lin Yang, Bao-Ding Zhuang, Ya-Wen Cao, Zhan-Yi Xiao, Shun-Qian Wen
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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.

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肝内胆管结石的外科治疗进展。
肝内胆管结石是一种常见病。肝内胆管结石是一种具有地域性的疾病。本病并发症及术后复发率高。肝内胆管癌和肝硬化的发生是导致肝内胆管结石患者死亡的主要原因。因此,它很难治疗。大多数胆结石都可以在内镜下切除,然而复杂的肝内或大的难治性肝外结石往往需要手术或经皮介入,当标准的内镜方法失败时。目前临床上治疗肝内胆管结石的主要方法是手术,根据患者的情况有不同的方法。随着医疗技术的不断更新和发展,肝内胆管结石的治疗也在不断提高。本文就临床应用的肝部分切除术、胆胆空肠吻合术、胆道探查取石术、经皮经肝胆道镜碎石术、肝移植等几种主流手术方法进行综述,供临床医生参考。根据每个病例的特点,选择合适的手术方式,以获得最佳的治疗效果。
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