New Surgical Technique for Bilateral Hepatolithiasis

Abstract

Background/Aims: Treatmant for hepatolithiasis is characterized by high failure and recurrence rates. In the past, surgery played a major role in the management of this disease, but the development of percutaneous transhepatic cholangioscopy and lithotripsy has played an important role in the treatment of these patients. Therefore, we undertook this prospective study to assess the role of surgery in the treatment of bilateral intractable hepatolithiasis in new era of the endoscopy.

Methods: We evaluated our results of 12 patients with bilateral intrahepatic stones treated by preoperative percutaneous transhepatic cholangioscopic approach and new definitive surgical approach (suprahilar approach and hilar cholangiotomy).

Results: The rate of complete stone removal was 100%. There was no incidence of procedure and operative mortality.

Conclusions: In this new endoscopic era, we carefully foresee that the major role of surgical treatment may be concentrated in the intractable cases of hepatolithiasis. Therefore, we suggest that more definitive surgery must be tried in the treatment of intractable bilateral hepatolithiasis.