Lorio Eric, Patel Pavan, Rosenkranz Laura, Patel Sandeep, Sayana Hari
Department of Internal Medicine, UT Health San Antonio - Long School of Medicine, San Antonio, TX, 78229-3900, USA.
Division of Gastroenterology & Nutrition, Department of Medicine, UT Health San Antonio - Long School of Medicine, MC 7878, 7703 Floyd Curl Dr., San Antonio, TX, 78229-3900, USA.
Curr Gastroenterol Rep. 2020 May 7;22(6):30. doi: 10.1007/s11894-020-00765-3.
Hepatolithiasis is a disease characterized by intrahepatic stone formation. In this article, we review the features of this disease and explore the established and emerging treatment modalities.
Recent reports show an increasing prevalence of hepatolithiasis, likely owed to increased immigration and shifts in the Western diet. New pharmacotherapy options are limited and are often only supportive. Endoscopic intervention still cruxes on removal of impacted stones, though new techniques such as bile duct exploratory lithotomy and lithotripsy continue to advance management. Although hepatectomy of the effected portion of the liver offers definitive therapy, alternative less invasive modalities such as combined endoscopic/interventional radiology modalities have been utilized in select patients. Additionally, liver transplant serves as an option for otherwise incurable hepatolithiasis with coexisting liver dysfunction. Multiple emerging pharmacologic and procedural interventions may provide novel treatment for hepatolithiasis. While definitive therapy remains resection of affected liver segments, these modalities offer hope for less invasive approaches in the future.
肝内胆管结石病是一种以肝内结石形成为特征的疾病。在本文中，我们回顾了该疾病的特点，并探讨了已有的和新出现的治疗方式。
最近的报告显示肝内胆管结石病的患病率呈上升趋势，这可能归因于移民增加和西方饮食结构的改变。新的药物治疗选择有限，且通常仅起支持作用。内镜干预仍主要集中在清除嵌顿结石，不过诸如胆管探查取石术和碎石术等新技术不断推动治疗进展。虽然对肝脏受累部分进行肝切除术可提供确定性治疗，但在部分患者中已采用了如内镜/介入放射学联合治疗等侵入性较小的替代方式。此外，肝移植是治疗伴有肝功能不全的无法治愈的肝内胆管结石病的一种选择。多种新出现的药物和手术干预措施可能为肝内胆管结石病提供新的治疗方法。虽然确定性治疗仍然是切除受累肝段，但这些方式为未来采用侵入性较小的方法带来了希望。
