Indications and therapeutical options in hepatolithiasis.
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.
Ramia
J M
JM
Unit of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Service of Gastrointestinal Surgery, Hospital Virgen de las Nieves, Granada, Spain. jose_ramia@hotmail.com
Palomeque
A
A
Muffak
K
K
Villar
J
J
Garrote
D
D
Ferrón
J A
JA
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