Diagnosis and treatment of intrahepatic stone complicated with atrophy-hypertrophy complex / 中华普通外科杂志

ABSTRACT

Objective To explore the typing and surgical methods on intrahepatic stone complicated with atrophy-hypertrophy complex.Methods The clinical data of 32 cases of intrahepatic stone complicated with atrophy-hypertrophy complex from January 2014 to December 2015 in Hunan Province Peopole's Hospital were retrospectively analysed.Results These 32 cases of atrophy-hypertrophy complex accounted for 1.9％ of admitted hepatolith patients.We divided the intrahepatic stone complicated with atrophy-hypertrophy syndrome into 5 types,and type-Ⅱ the most common.We performed operation combined with fiber choledochoscope to examine,smash and remove the stone.This methods could reduce the rate of residual stone to 6％.The liver will be partly atrophy with stones inside it,and the residual liver will become hypertrophy.Stones of intrahepatic bile duct lead to the change of the position of porta hepatis and straitness of primary bile duct,and the bile cannot smooth out.there will be lithogenesis and relapsing cholangitis.Patients were treated by intrahepatic biliary double-opening drainage,and followed-up for 12-36 months.There were no death cases,and the total effective rate was 94％.Conclusions Intrahepatic stones complicated with atrophy-hypertrophy complex could be diagnosed by CT scan.Selecting proper operation method to treat atrophy-hypertrophy complex may decrease residual stones and improve the quality of life.