title: Surgical therapy for hepatolithiasis: a Western experience.
abstract: BACKGROUND
  Hepatolithiasis is very common in East Asia but infrequent in Western countries, and few reports have been published in European series. In East Asia, the association between cholangiocarcinoma and hepatolithiasis is well recognized, but, on the contrary, hepatolithiasis is uncommon in Europe and the United States, and the relationship with cholangiocarcinoma is not well established. The goal of this study was to analyze the perioperative and longterm results of surgical therapy for hepatolithiasis.
  
  
  METHODS
  Record review of 22 patients was done to locate immediate (operative morbidity and mortality) and longterm (stone recurrence and survival) results of patients with hepatolithiasis who underwent surgical treatment.
  
  
  RESULTS
  There were 19 (86.4%) hepatic resections and 10 (45.5%) hepatico-jejuno-anastomoses. Operative mortality was absent and morbidity rate was 27.3%. Right hepatectomy was predictive of postoperative complications at multivariate analysis (p = 0.04). One (4.5%) patient had an unknown associated cholangiocarcinoma at time of surgical intervention. Mean followup was 67.59 +/- 65.67 (range 12 to 215) months. None presented recurrent cholangitis during the followup period.
  
  
  CONCLUSIONS
  Surgical therapy is a safe and effective management for hepatolithiasis. The possibility of developing cholangiocarcinoma in inveterate hepatolithiasis is real, and hepatic resection removes this risk.
authors.affiliation: Department of Liver and Multiorgan Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vetrone
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ercolani
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ramacciato
authors.forename: Matteo
authors.initials: M
authors.lastname: Ravaioli
authors.forename: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Giovanni
authors.initials: G
authors.lastname: Varotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Gaudio
authors.forename: Cristiano
authors.initials: C
authors.lastname: Quintini
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000368:Aged; D002137:Calculi / Q000453:epidemiology / Q000601:surgery*; D002763:Cholecystectomy; D015897:Comorbidity; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies