ABSTRACT
Hepatolithiasis is a disease which stone firstly occurs in intrahepatic bile duct system.This disease has complex pathogenetic condition, extensive lesion.It also has high recurrence rate, residual stone rate and complication occurrence rate.And at the same time, it has possibility to be canceration.At present, hepatectomy is considered to be the best approach to treat hepatolithiasis.What's more, there are also some other therapies, such as transhepatic cholangiolithotomy, bile duct stricture repair revascularization, liver transplatation and non-operation treatment, and so on.In recent years, the symptom of hepatolithiasis in our country becomes lighter, the range becomes more limited, and the course becomes more early.However, this disease is still a big challenge for hepatobiliary surgeon.In this article, we review the epidemiology, pathogenesis and treatment progress of hepatolithiasis.
ABSTRACT
Objective To investigate the function of mucin 2,mucin 4 on formation of lithogenic bile in patients with calculus of intrahepatic duct.Methods Bile duct mucosa,bile duct wall,bile and plasma were collected from 56 patients with calculus of intrahepatic duct (CID group) and 17 individuals without calculus of intrahepatic duct (control group).The bile duct wall was stained with mucin 2 (MUC2) and mucin 4 (MUC4).Reverse-transcription polymerase chain reaction (RT-PCR) was applied to study the mRNA expressions of MUC2 and MUC4 in the bile duct mucosa.The correlation of the bile duct and serum lipid index was analyzed.Results Serum lipid index in the CID group was significantly higher than control group (all P＜0.05).Biliary total bile acids and bile acids mol percentage were lower in the CID group than control group (both P＜0.05).The expressions of MUC2 was not increased significantly in CID group than the control group (all P＞0.05).The expressions of MUC4 were more significantly increased in CID group than the control group (P＜0.05).The mRNA of MUC4 in the CID group was also more significantly increased than in control group (P＜0.01).There were no correlations between MUC4 expression and the level of biliary total bile acid in the CID group (r=-0.374,P＜0.05).Conclusion The expression of MUC4 in patients with CID was enhanced,which promoted the absorption of bile acid by the mucosal epithelium of the bile duct,and caused a large amount of mucin to be secreted into bile,which may be related to the formation of stony bile.