Follow-up results in a long term in nonoperated patients with the intrahepatic and the predominant intrahepatic type of hepatolithiasis

Abstract

In order to clarify therapeutic principles of hepatolithiasis associated with a variety of pathological conditions, we studied follow-up results in a term of 5 years after diagnosis in 29 nonoperated patients with intrahepatic gallstones. The patients including 14 males and 15 females underwent direct cholangiography for making diagnosis of the disease consisting of the intrahepatic type (I) and the predominant intrahepatic (IE). Out of the patients, 21 had good results in the follow-up and no one died from the disease or cholangiocarcinoma incidentally occurred. The follow-up results were closely related with the distribution and the location of gallstones in the liver and the grade of severity in clinical symptoms at the diagnosis. The unilateral lober type of the stone distribution had better follow-up results than the bilateral (P<0.01), and the peripheral intrahepatic bile duct type of the stone location did better follow-up results than the major (P<0.01). The pathological state of mild clinical symptoms showed better follow-up results than that of severe ones (P<0.05). The removal of coexisted extrahepatic bile duct stones by endoscopic papillotomy was effective for improving clinical symptoms. The conservative treatment in hepatolithiasis with the type I or IE was generally good in the follow-up results. The follow-up results were various, depending on the pathological conditions at the diagnosis. Accordingly, the treatment of hepatolithiasis must be selected in consideration of pathological conditions.