Understanding and reflection on the standardized treatment of hepatolithiasis
10.7659/j.issn.1005-6947.250033
- VernacularTitle:对肝内胆管结石规范性治疗的认识与思考
- Author:
Jian WANG
1
Author Information
1. 上海交通大学医学院附属第六人民医院 肝胆胰外科,上海 200233
- Publication Type:Journal Article
- Keywords:
Cholelithiasis;
Bile Ducts,Intrahepatic;
Standardized Treatment;
Perihilar Surgical Techniques
- From:
Chinese Journal of General Surgery
2025;34(2):238-244
- CountryChina
- Language:Chinese
-
Abstract:
The difficult radical cure of intrahepatic bile duct stones is attributed to their tendency to leave residues and recur.Therefore,it is crucial to raise awareness of the importance of standardized treatment.The inability to perform true anatomical liver resection and effectively correct bile duct stenosis are the root causes of stone retention and recurrence.Precise and comprehensive preoperative assessment is the prerequisite for standardized treatment.Attention should be focused on evaluating the distribution of stones,biliary strictures,the function of the Oddi sphincter,as well as the anatomical variations of the hepatic artery,bile duct,and portal vein.Therefore,the author proposed the LHO classification and CRL classification to guide decision-making.High-quality and meticulous surgery is the core of standardized treatment.Timely and correct management of complications and standardized postoperative follow-up throughout the process are the guarantee and continuation of standardized treatment.By integrating various techniques such as perihilar surgical techniques,and strictly adhering to the"removing lesions,removing all stones,correcting strictures,and ensuring unobstructed drainage"principle,standardized treatment can improve the safety and effectiveness of the treatment of intrahepatic bile duct stones,reducing the stone retention and recurrence rates.
