Hepatectomy for Intrahepatic Stones

Mitsuji Nakamura

The Institute of Gastroenterology, Tokyo Women's Medical College

Based on our experience of 186 cases of intrahepatic stones duing the last 2l years, the cause, when advisability of liver resection, and results and prognosis, are discussed. There are two causes of intrahepatic stones, congenital and acquired. Among the congenital cases, which have increase dyear by year,73% undenwent hepatic resection. It is advisable to perform liver resection in congenital cases such as these caused by stenosis and cystic dilatation of the intrahepatic bile duct and in acquired cases caused by major disturbance of the liver parenchyma and liver abscesses. Liver resection was performed in 66 cases, none of them died whithin one month after surgery. It goes without saying that today, hepatic resection is a safe surgical procedure. In 95% of the cases with stones in either the right or left lobe of the liver, a good prognosis was obtained by hepatic resection, which is now considered curative. In situations where stones were in both lobes of the liver, hemihepatectomy was perfomed to resect the lobe with the main lesion and then the residual stones in the other lobe were extracted non-operativity. Good results were obtained in 77% of cases. It is usually best to remove the dilated duct and stenotic portion of the intrahepatic bile duct thoroughly, otherwise recurrence is likely.

Key words
intrahepatic stones, pathogenesis of intrahepatic stones, hepatectomy for intrahepatic stones

Reprint requests
Mitsuji Nakamura Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
October 11, 1989

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