Napolitano L, Cotellese R, Ricci A, Gargano E
Istituto di Patologia Chirurgica, Università degli Studi di Chieti.
Ann Ital Chir. 1996 Sep-Oct;67(5):647-50; discussion 651.
The authors report a case of intrahepatic lithiasis in a patient already operated of cholecystectomy and without lithiasis of the common bile duct. The lithiasis was present in the left lateral bile duct, was multiple and trapped behind a very narrow stricture. The stones were associated with a marked dilatation of the involved biliary ducts, cholangitis, fibrosis and atrophy of surrounding hepatic parenchyma. It was performed a resection of the II and III hepatic segments and the patient recovered completely and is well and disease free after one year. The authors believe, also on the base of the data reported by others, that in the intrahepatic lithiasis with strictures of the bile intrahepatic ducts the hepatic resection is the treatment of choice, especially when the lithiasis is present in a sectorial or segmental bile duct, preventing any stone recurrence.
作者报告了一例肝内结石病例，该患者已接受胆囊切除术且胆总管无结石。结石位于左肝外胆管，为多发，并嵌顿在一个非常狭窄的狭窄段后方。结石伴有受累胆管的明显扩张、胆管炎、纤维化以及周围肝实质萎缩。实施了肝Ⅱ和Ⅲ段切除术，患者完全康复，一年后情况良好且无疾病。作者基于其他人报告的数据也认为，对于存在肝内胆管狭窄的肝内结石，肝切除术是首选治疗方法，尤其是当结石位于扇形或段性胆管时，可防止结石复发。
