Ye Yong-Qing, Li Pei-Heng, Wu Qing, Yang Shang-Lin, Zhuang Bao-Ding, Cao Ya-Wen, Xiao Zhan-Yi, Wen Shun-Qian
Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China.
Department of Oncology, Foshan Nanhai District Fifth People's Hospital, Foshan 528000, Guangdong Province, China.
World J Gastrointest Surg. 2024 Dec 27;16(12):3666-3674. doi: 10.4240/wjgs.v16.i12.3666.
Hepatolithiasis is a common disease where stones are located in the intrahepatic bile duct. Hepatolithiasis is a disease with regional characteristics. The complication and postoperative recurrence rates of the disease are high. The intrahepatic cholangiocarcinoma and the incidence of liver cirrhosisare the main causes of death in patients with hepatolithiasis. Thus, it is difficult to treat. The majority of biliary stones are readily removed endoscopically, however complex intrahepatic or large refractory extrahepatic stones often require surgical or percutaneous interventions when standard endoscopic methods fail. At present, the main clinical treatment for hepatolithiasis is surgery, of which there are different methods depending on the patient's condition. With the continuous updates and development of medical technology, the treatment of hepatolithiasis has improved. In this paper, several mainstream surgical methods including partial hepatectomy, choledochojejunostomy, biliary tract exploration and lithotomy, percutaneous transhepatic chledochoscopic lithotripsy and liver transplantation used in the clinic are reviewed for clinicians' reference. Depending on the characteristics of each case, a suitable surgical method is chosen to obtain the best treatment effect.
肝内胆管结石是一种结石位于肝内胆管的常见疾病。肝内胆管结石是一种具有地域特征的疾病。该疾病的并发症和术后复发率较高。肝内胆管癌和肝硬化的发生率是肝内胆管结石患者的主要死因。因此，其治疗难度较大。大多数胆管结石可通过内镜轻松取出，然而，当标准内镜方法失败时，复杂的肝内结石或难治性肝外大结石通常需要手术或经皮介入治疗。目前，肝内胆管结石的主要临床治疗方法是手术，其中根据患者病情有不同的手术方式。随着医学技术的不断更新和发展，肝内胆管结石的治疗已有改善。本文对临床上使用的几种主流手术方法进行综述，包括肝部分切除术、胆总管空肠吻合术、胆道探查取石术、经皮经肝胆道镜碎石术和肝移植术，以供临床医生参考。根据每个病例的特点，选择合适的手术方法以获得最佳治疗效果。
