Intrahepatic Stone

  • Ichiro Yasuda
  • Shinpei Doi
  • Masatoshi Mabuchi


Surgical resection of the affected liver segment has been considered to play a primary role in treating intrahepatic stones, because of their strong association with intrahepatic cholangiocarcinoma and the high incidence of recurrent stones after nonoperative treatments. Percutaneous transhepatic cholangioscopy-guided lithotripsy (PTCS-L) is safe and effective for removing intrahepatic stones when surgical resection is not suitable or is refused by patients. However, if the patient had biliary stricture, the stricture should be carefully evaluated in order not to overlook accompanying biliary cancer. In addition, stones should be removed as completely as possible, and the stricture should be treated to reduce later complications such as recurrent stones and cholangiocarcinoma. The endoscopic transpapillary approach is also available in cases without biliary stricture. However, its indication for intrahepatic stones remains controversial because of its low success rate and high recurrence rate. In postoperative cases (after hepaticojejunostomy), PTCS-L has also been attempted. However, more recently, balloon-assisted enteroscopes have also been used for stone extraction in postoperative cases.


Intrahepatic stone PTCS POCS Enteroscope 


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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Ichiro Yasuda
    • 1
  • Shinpei Doi
    • 1
  • Masatoshi Mabuchi
    • 1
  1. 1.Department of GastroenterologyTeikyo University Mizonokuchi HospitalKawasakiJapan

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