title: Indications and therapeutical options in hepatolithiasis.
abstract: OBJECTIVE
  to present our experience with the treatment of hepatolithiasis.
  
  
  METHODS
  
  
  
  METHODS
  a retrospective study. Every patient operated on during 2002-2004.
  
  
  RESULTS
  mean age was 68.2 years. All patients were male. Two patients had been operated on before. The other three suffered from: monolobar Caroli s disease (1), cholangiocarcinoma (1), and hepatolihtiasis without clear etiologic factors (1). All of them had intrahepatic and extrahepatic litihiasis. Clinical signs included: pain in RUQ, fever, and jaundice. Bilirubin was 3.5 mg/dl (min: 1.7, max: 5.9), GGT: 676.2 IU/l (min: 29, max: 2039), and alkaline phosphatase: 400 IU/l (min: 100, max: 1136). Abdominal ultrasounds always correctly diagnosed HL. CT (3 patients) only diagnosed one case. ERCP (3 patients) and cholangio-MRI (2 patients) always diagnosed HL correctly. Surgical procedures were: hepatojejunostomy with lavage of bile duct (2 cases) and hepatectomy (3 cases) -both right (1) and left (2). We always performed an intraoperative ultrasonography and choledoscopy. Morbidity was: biliary fistula (1 case) treated by percutaneous drainage. No mortality occurred. Median stay was 8.8 days. Mean follow-up is 12 months (min: 11, max: 20). No relapse has been observed.
  
  
  CONCLUSIONS
  HL is infrequent in Spain. Surgical treatment, usually liver resection, obtains good results with low morbidity and mortality.
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Service of Gastrointestinal Surgery, Hospital Virgen de las Nieves, Granada, Spain. jose_ramia@hotmail.com
authors.forename: J M
authors.initials: JM
authors.lastname: Ramia
authors.forename: A
authors.initials: A
authors.lastname: Palomeque
authors.forename: K
authors.initials: K
authors.lastname: Muffak
authors.forename: J
authors.initials: J
authors.lastname: Villar
authors.forename: D
authors.initials: D
authors.lastname: Garrote
authors.forename: J A
authors.initials: JA
authors.lastname: Ferrón
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002137:Calculi / Q000175:diagnosis / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D020347:Lithiasis / Q000175:diagnosis / Q000601:surgery*; D008099:Liver / Q000473:pathology / Q000601:surgery; D008107:Liver Diseases / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome