Abstract
We reviewed eight patients with intrahepatic stones (3 men and 5 women, 36 to 74 years of age) experienced in the Yokohama National Hospital over the last 5 years. Both intra- and extrahepatic stones were noticed in 6 patients and only intrahepatic stones in 2 cases. As to the location of the stone in intrahepatic biliary system, 5 patients had the stones in the left intrahepatic bile ducts and 3 had them in the both right and left intra-hepatic bile ducts. Ductal strictures of intrahepatic billiary tract were detected in 3 patients and no ductal stricture in 5 patients. Ductal strictures were seen in the biliary tract of left lateral segment in 2 patients, right hepatic duct in one patient and common hepatic duct in one. All patients having no ductal stricture underwent cholecystectomy with choledochotomy and drainage, one with transduodenal papilloplasty and one with hepatic lobectomy. Although complete removal of intrahepatic stones was not done in 2 of the cases, they remained asymptomatic in the follow-up period. Patients with ductal stricture underwent choledochotomy, one with hepatic lobectomy and one had only common hepatic duct drainage. Intrahepatic residual stones were noted at time of the discharge in 2 of the 3 cases. Although one of them was asymptomatic, another became symptomatic again after 6 months. The case was treated with transcutaneous transhepatic cholangioscopy and we finally removed all the stones.
