caa a22 4500 475801504 CHVBK 20180406123738.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s002689910114 doi (NATIONALLICENCE)springer-10.1007/s002689910114 Treatment of Complicated Hepatolithiasis with Intrahepatic Biliary Stricture by Ductal Dilatation and Stenting: Long-term Results [Elektronische Daten] [Yu Fan Cheng, Tze Yu Lee, Shyr Ming Sheen-Chen, Tung Liang Huang, Tai Yi Chen] Abstract.: A group of 190 cases of hepatolithiasis with postoperative residual stones located proximal to the stricture sites were managed with the aim of complete clearance of stones and relief of bile stasis to decrease the potential risk of recurrence. All procedures were performed through a T-tube track with gradual dilatation and stent placement through the stricture sites, creating a channel that allows cholangioscopy and electrohydraulic lithotripsy. Complete clearance of intrahepatic duct (IHD) stones was achieved in 88.4% of cases. Multiple sharply angulated IHD strictures in right-sided hepatolithiasis constituted a major cause of failure. Recurrent stone formation and repeated cholangitis, subsequent drainage, and liver resection are associated with high mortality rates particularly if there is late development of a cholangiocarcinoma. We concluded that postoperative ductal dilatation and stenting through the T-tube track combined with endoscopic electrohydraulic lithotripsy is effective and safe for managing complicated hepatolithiasis. Persistent irreversible aneurysmal dilatation of IHD and atrophic change of the affected hepatic lobe at follow-up were ominous signs of recurrence and cholangiocarcinoma development. Early drainage with stone extraction combined with surgical intervention can prevent subsequent morbidity and mortality. 2000 by the Société Internationale de Chir, 2000 Cheng Yu Fan Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut Lee Tze Yu Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut Sheen-Chen Shyr Ming Department of General Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut Huang Tung Liang Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut Chen Tai Yi Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut World Journal of Surgery Springer-Verlag 24/6(2000-06-01), 712-716 0364-2313 24:6<712 2000 24 268 https://doi.org/10.1007/s002689910114 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910114 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cheng Yu Fan Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut NATIONALLICENCE 700 1- Lee Tze Yu Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut NATIONALLICENCE 700 1- Sheen-Chen Shyr Ming Department of General Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut NATIONALLICENCE 700 1- Huang Tung Liang Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut NATIONALLICENCE 700 1- Chen Tai Yi Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan, Taiwan aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/6(2000-06-01), 712-716 0364-2313 24:6<712 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer