Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec 20;32(4):e1463.
doi: 10.1590/0102-672020190001e1463. eCollection 2019.

LIVER RESECTION FOR NON-ORIENTAL HEPATOLITHIASIS

[Article in English, Portuguese]
Orlando Jorge Martins Torres  1 , Marcelo Moura Linhares  2 , Eduardo José B Ramos  3 , Paulo Cezar G Amaral  4 , Marcos Belotto  5 , Angelica Maria Lucchese  6 , Romerito Fonseca Neiva  1 , Theago Medeiros Freitas  1 , Rodolfo Santana  5 , Josiel Paiva Vieira  1 , Jaldo Santos Freire  1 , Camila Cristina S Torres  1 , Antonio Nocchi Kalil  6
Affiliations

LIVER RESECTION FOR NON-ORIENTAL HEPATOLITHIASIS

[Article in English, Portuguese]
Orlando Jorge Martins Torres et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Background: Primary intrahepatic lithiasis is defined when the stones are formed in the liver and associated with local dilatation and biliary stricture. Liver resection is the ideal procedure.

Aim: To evaluate the results of liver resection in the treatment of non-oriental intrahepatic lithiasis.

Methods: Fifty-one patients with symptomatic benign non-oriental hepatolithiasis underwent surgical resection in six institutions in Brazil. Demography data, clinical symptoms, classification, diagnosis, management and postoperative course were analyzed.

Results: Of the 51 patients, 28 were male (54.9%), with a mean age of 49.3 years. History of cholangitis was observed in 15 (29.4%). The types of intrahepatic lithiasis were type I in 39 (76.5%) and type IIb in 12 (23.5%), with additional type Ea in six (11.8%). Liver function test were normal in 42 patients (82.4%). Segmental atrophy was observed in 12 (23.5%). Treatments included left lateral sectionectomy in 24 (47.1%), left hepatectomy in 14 (27.5%) and right hepatectomy in eight (15.7%), with associated hepaticojejunostomy in four (7.8%). Laparoscopic liver resection was performed in eight (15.7%). Postoperative complications were observed in 20 (39.2%) with no mortality.

Conclusion: Liver resection in patients with hepatolithiasis is the ideal procedure as it removes stones, stricture, atrophic parenchyma, and minimizes the risk of cholangiocarcinoma.

Racional:: Litíase intra-hepática primária é definida quando os cálculos são formados dentro do fígado, podendo estar associada à dilatação local e estenosa da via biliar. A ressecção hepática é considerada o procedimento ideal.

Objetivo:: Avaliar os resultados da ressecção hepática no tratamento da litíase intra-hepática não oriental.

Métodos:: Cinquenta e um pacientes com hepatolitíase benigna não oriental sintomática foram submetidos à ressecção hepática em seis instituições no Brazil. Os dados demográficos, sintomas clínicos, classificação, diagnóstico, tratamento e evolução pós-operatória foram analisados.

Resultados:: Dos 51 pacientes havia 28 homens (54,9%), e a idade média era de 49,3 anos. História de colangite foi observada em 15 pacientes (29,4%). Os tipos de litíase observados foram tipo I em 39 (76,5%) e tipo IIb em 12 (23,5%), com o tipo adicional Ea em seis pacientes (11,8%). Os testes de função hepática estavam normais em 42 (82,4%) e atrofia segmentar foi observada em 12 (23,5%). O tratamento incluiu setorectomia lateral esquerda em 24 (47,1%), hepatectomia esquerda em 14 (27,5%) e hepatectomia direita em oito pacientes (15,7%). A hepaticojejunostomia esteve associada ao procedimento inicial em quatro (7,8%). Hepatectomia por videolaparoscopia foi realizada em oito (15,7%). Complicações pós-operatórias foram observadas em 20 pacientes (39,2%) e não houve mortalidade.

Conclusão:: Ressecção hepática na hepatolitíase é o procedimento ideal, pois remove os cálculos, a estenose, o parênquima atrofiado e minimiza os riscos para colangiocarcinoma.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none

Figures

FIGURE 1
FIGURE 1. A) Segmental atrophy in patient with hepatolithiasis; B) huge intrahepatic stone
FIGURE 2
FIGURE 2. A and B) Left lateral sectionectomy due to hepatolithiasis in patient with atrophy; C and D) without
FIGURE 3
FIGURE 3. A) Hepaticojejunostomy after left lateral sectionectomy; B) intrahepatic bile duct is occluded after clearance
See this image and copyright information in PMC

References

    1. Clemente G, De Rose AM, Murri R, Ardito F, Nuzzo G, Giuliante F. Liver resection for primary intrahepatic stones focus on postoperative infectious complications. World J Surg. 2016;40:433–439. - PubMed
    1. Feng X, Zheng S, Xia F, Ma K, Wang S, Bie P, Dong J. Classification and management of hepatolithiasis A high-volume, single-center's experience. Intract Rare Dis Res. 2012;1:151–156. - PMC - PubMed
    1. Fonseca GM, Jeismann VB, Kruger JAP, Coelho FF, Montagnini AL, Herman P. Liver resection in brazil a national survey. Arq Bras Cir Dig. 2018;31:1–5. - PMC - PubMed
    1. Giménez ME, Houghton EJ, Davrieux CF, Serra E, Pessaux P, Palermo M, Acquafresca PA, Finger C, Dallemagne B, Marescaux J. Percutaneous radiofrequency assisted liver partition with portal vein embolization for staged hepatectomy (PRALPPS) Arq Bras Cir Dig. 2018;31:1–4. - PMC - PubMed
    1. Herman P, Bacchella T, Pugliese V, Montagnini AL, Machado MA, Cunha JEM, Machado MC. Non-Oriental Primary Intrahepatic Lithiasis Experience with 48 Cases. World J. Surg. 2005;29:858–864. - PubMed