Treatment of Intrahepatic Lithiasis

  • Yuji Nimura


The percutaneous approach for the non-surgical treatment of intrahepatic stones was developed with flexible cholangioscopy via a T-tube sinus tract to remove retained intrahepatic stones after intraoperative choledochohepaticolithotomy through choledochotomy [1, 2]. Another route of percutaneous cholangioscopic lithotomy was established through choledochojejunostomy with subcutaneous jejunostomy after intraoperative choledochohepaticolithotomy [3]. Further development of interventional techniques and fiber optic flexible cholangioscopes enabled percutaneous transhepatic cholangioscopy (PTCS) via dilated sinus tract of percutaneous transhepatic biliary drainage (PTBD) (Fig. 39.1) [4, 5, 6, 7, 8].


Biliary Stenosis Percutaneous Transhepatic Biliary Drainage Residual Stone Left Hepatic Duct Intrahepatic Stone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Yamakawa T, Komaki F, Shikata J (1978) Experience with routine postoperative choledochoscopy via the T-tube sinus tract. World J Surg 2:379–385PubMedCrossRefGoogle Scholar
  2. 2.
    Chen MF, Jan YY, Chou FF et al (1983) Use of fiberoptic choledochoscope in common bile duct and intrahepatic duct exploration. Gastrointest Endosc 29:276–278PubMedCrossRefGoogle Scholar
  3. 3.
    Ker CG, Kuo KK, Tsai CC et al (1994) Evaluation if choledochojejunostomy with subcutaneous jejunostomy for treatment of intrahepatic stones. Int Surg 79:110–113PubMedGoogle Scholar
  4. 4.
    Nimura Y, Hayakawa N, Toyoda S et al (1981) Percutaneous transhepatic cholangioscopy. Stomach Intestine (Japanese with English abstract) 16:681–689Google Scholar
  5. 5.
    Nimura Y (1984) Percutaneous transhepatic cholangioscopy (PTCS) in the treatment of intrahepatic stones. In: Sheen PC, Ker CG (eds) Gallstone and Choledochoscope. Kaohsiung, Mei Yue, pp 71–85Google Scholar
  6. 6.
    Nimura Y, Shionoya S, Hayakawa N et al (1988) Value of percutaneous transhepatic cholangioscopy (PTCS). Surg Endosc 2:213–219PubMedCrossRefGoogle Scholar
  7. 7.
    Chen MF, Jan YY (1986) Percutaneous transhepatic removal of common bile duct and intrahepatic duct stones with a fiberoptic choledochoscope. Gastrointest Endosc 32:347–349PubMedCrossRefGoogle Scholar
  8. 8.
    Chen MF, Jan YY, Lee TY (1987) Percutaneous transhepatic cholangioscopy. Br J Surg 74:728–730PubMedCrossRefGoogle Scholar
  9. 9.
    Yeh YH, Huang MH, Yang JC et al (1995) Percutaneous trans-hepatic cholangioscopy and lithotripsy in the treatment of intrahepatic stones: a study with 5 year follow-up. Gastrointest Endosc 42:13–18PubMedCrossRefGoogle Scholar
  10. 10.
    Kondo S, Nimura Y, Hayakawa N et al (1995) A clinicopathologic study of primary cholesterol hepatolithiasis. Hepatogastroenterology 42:478–486PubMedGoogle Scholar
  11. 11.
    Strichartz SD, Abedin MZ, Ippoliti AF et al (1991) Intrahepatic cholesterol stones: a rationale for dissolution therapy. Gastroenterology 100:228–232PubMedGoogle Scholar
  12. 12.
    Jan YY, Chen MF, Wang CS et al (1996) Surgical treatment of hepatolithiasis: long-term results. Surgery 120:509–514PubMedCrossRefGoogle Scholar
  13. 13.
    Chen MF, Jan YY, Wang CS et al (1997) Role of hepatic resection in surgery for bilateral intrahepatic stones. Br J Surg 84:1229–1232PubMedCrossRefGoogle Scholar
  14. 14.
    Chen DW, Poon RTP, Liu CL et al (2004) Immediate and long-term outcomes of hepatectomy for hepatolithiasis. Surgery 135:386–393PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Yuji Nimura
    • 1
  1. 1.Department of Digestive SurgeryAichi Cancer CenterNagoyaJapan

Personalised recommendations