Treatment of hepatolithiasis by chemical bile duct embolization: report on 2 cases.
The high recurrence of hepatolithiasis has not been settled effectively until now, which lead us to present a new therapy of the chemical bile duct embolization to resolve it. In our selected 2 patients, multiple biliary calculi, complicated by biliary stricture, were found in the inferior branch of left lateral bile duct via preoperative cholangiography. After the choledochoscopic cholelithotomy, the combination of absolute ethanol and N-butyl-cyanoacrylate were injected into the diseased biliary duct lumen. Two months later, their T-tube cholangiography demonstrated that the targeted biliary ducts were completely embolized, thus effectively preventing the calculous recurrence. Twelve and 15 months later, their computed tomography scan showed that the inferior segments of left lateral lobes were almost completely atrophied and disappeared, thus successfully achieving the chemical "resection" of the diseased hepatic lobe. Chemical bile duct embolization may be a feasible and safe technique to prevent the calculous recurrence and concurrently achieve the effect of chemical hepatectomy for highly selected hepatolithiasis cases.
Li
Fu Yu
FY
Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China. lfy_74@vip.163.com
Jiang
Li Sheng
LS
Cheng
Jing Qiu
JQ
Mao
Hui
H
Li
Ning
N
Cheng
Nan Sheng
NS
Zhang
Yong Qiong
YQ
D001649:Bile Duct Diseases / Q000188:drug therapy*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D016461:Chemoembolization, Therapeutic; D002769:Cholelithiasis / Q000188:drug therapy*; D005260:Female; D042882:Gallstones; D006498:Hepatectomy; D006801:Humans; D008875:Middle Aged