Fianchini A, Suraci V, Landa L, Paielli O, Cutini G
Chir Ital. 1977 Aug;29(4):335-48.
After a short synthesis of the elements characterising intrahepatic calculosis, and evaluation of the five cases considered, the value of cholangiography (both intravenous and instrumental) and of radio-scintiscanning with Bengal Rose marked with I131 in pre-operative diagnosis is stressed. The intra-operative use of choledochoscopy in conjunction with cholangiography is recommended. With regard to treatment, it must ensure removal of the calculi and create an ample biliodigestive communication (papillectomy or, even better, hepaticojejunostomy on excluded Roux loop) in order to prevent recurrences. In order to visualise the intrahepatic branches of the bile ducts, the removal of the hilar plaque is advised, possibly combined with sagittal scissurectomy or mobilisation of the 4th segment. In conclusion it is asserted that correctly performed surgical treatment is the only means of offering permanent cure.
在简要综述了肝内结石病的特征性因素，并对所考虑的5例病例进行评估之后，强调了胆管造影（包括静脉胆管造影和器械胆管造影）以及用131I标记的孟加拉玫瑰进行放射性闪烁扫描在术前诊断中的价值。建议在手术中联合使用胆管镜检查和胆管造影。关于治疗，必须确保清除结石，并建立充分的胆肠吻合（乳头切除术，或者更好的是在游离的Roux袢上行肝空肠吻合术）以防止复发。为了看清肝内胆管分支，建议切除肝门部斑块，可能的话结合矢状裂切除术或第4肝段游离术。总之，有人断言，正确实施的外科治疗是实现永久治愈的唯一手段。
