<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>Long-term results of hepatic resection for hepatolithiasis in 34 patients having intrahepatic
biliary strictures were studied. The left lateral and the right posterior segmental ducts were
commonly and often simultaneously involved. Fourteen patients had multiple segmental
involvement. Hepatic resection included left sided resection (<italic>n</italic>=27), right sided resection (<italic>n</italic>=6), and repeated bilateral resection (<italic>n</italic>=1). Seven patients had biliary tumors: 3 cholangiocarcinomas, 2 gall bladder cancers, cystadenocarcinoma, and dysplasia of intrahepatic
ducts. Nineteen patients received bilioenteric anastomosis. Retained stones and recurrent
stones developed in 3 and 4 patients, respectively. Twenty-six patients had no remaining
symptoms; 2 died of operative complication or cholangiocarcinoma; 6 presented symptoms
caused by retained stones (<italic>n</italic>=2), recurrent stones (<italic>n</italic>=2), bile stasis (<italic>n</italic>=1), or neuralgia (<italic>n</italic>=1). In
4 of the 6 patients, unrelieved posterior duct strictures caused the symptoms. With a mean
follow-up period of 4.5 years, 30 patients are symptoms free, and 27 are stone free. In patients
with right lobar or bilobar type, intra- and extrahepatic type, and confluence strictures,
bilioenteric anastomosis is required. Hepatic resection is a rational treatment for hepatolithiasis,
however, meticulous management of biliary tract abnormalities, particularly the
posterior duct stricture, is mandatory.</p>
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HPB Surg. 1995; 9(1):37-41