[Personal case series of intrahepatic lithiasis].
Fifteen cases of intrahepatic lithiasis are reported, on 1798 operations for non malignant diseases of the biliary tract (0.8%), carried out by the Authors in the last 11 years. Two cases were described separately, consisting respectively of an "eastern" hepatolithiasis, and a secondary form, due to stenosis of a choledochoduodenostomy, which had been performed after surgical injury of the common bile duct. The other 13 patients had a "mixed" form. Jaundice was present in 8 of these cases, cholangitis in 4. Intrahepatic stones were diagnosed preoperatively in 3 cases and intraoperatively in 10. A bilioenteric anastomosis was carried out in 9 cases, a sphincteroplasty in 3, and a T-tube drainage in a patient with suppurative cholangitis. Two patients died postoperatively, both from sepsis: the first in the early postoperative phase, after emergency operation for cholangitis; the other, with "primitive" hepatolithiasis, 3 months after the operation. Clinical results are satisfactory after 1-11 years. On the basis of data from current literature, diagnostic and therapeutic aspects are set forth, with specific reference to the mixed and secondary forms: the bilioenteric anastomoses seem to give better chances of success, but the need to have access to lobar ducts may sometimes impose hilar derivations. Spincteroplasty may have a few indications, solely in selected patients.
Violi
V
V
Università degli Studi di Parma Istituto di Clinica Chirurgica Generale e Terapia Chirurgica II.
Roncoroni
L
L
Montanari
M
M
Peracchia
A
A
D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
Osservazioni personali in tema di calcolosi intraepatica.