Hepatolithiasis:Epidemiology,presentation,classification and management of a complex disease  

作　　者：Rodrigo V.Motta Francesca Saffioti Vasileios K Mavroeidis 

机构地区：[1]Translational Gastroenterology and Liver Unit,Nuffield Department of Medicine,University of Oxford,Oxford OX39DU,United Kingdom [2]Department of Gastroenterology and Hepatology,Oxford University Hospitals NHS Foundation Trust,John Radcliffe Hospital,Oxford OX39DU,United Kingdom [3]UCL Institute for Liver and Digestive Health and Sheila Sherlock Liver Unit,Royal Free Hospital and University College London,London NW32QG,United Kingdom [4]Department of HPB Surgery,Bristol Royal Infirmary,University Hospitals Bristol and Weston NHS Foundation Trust,Bristol BS28HW,United Kingdom [5]Department of Transplant Surgery,North Bristol NHS Trust,Southmead Hospital,Bristol BS105NB,United Kingdom [6]Department of Gastrointestinal Surgery,North Bristol NHS Trust,Southmead Hospital,Bristol BS105NB,United Kingdom

出　　处：《World Journal of Gastroenterology》2024年第13期1836-1850,共15页世界胃肠病学杂志（英文版）

摘　　要：The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts,above the hilar confluence of the hepatic ducts.The disease is more prevalent in Asia,mainly owing to socioeconomic and dietary factors,as well as the prevalence of biliary parasites.In the last century,owing to migration,its global incidence has increased.The main pathophysiological mechanisms involve cholangitis,bile infection and biliary strictures,creating a self-sustaining cycle that perpetuates the disease,frequently characterised by recurrent episodes of bacterial infection referred to as syndrome of“recurrent pyogenic cholangitis”.Furthermore,long-standing hepatolithiasis is a known risk factor for development of intrahepatic cholangiocarcinoma.Various classifications have aimed at providing useful insight of clinically relevant aspects and guidance for treatment.The management of symptomatic patients and those with complications can be complex,and relies upon a multidisciplinary team of hepatologists,endoscopists,interventional radiologists and hepatobiliary surgeons,with the main goal being to offer relief from the clinical presentations and prevent the development of more serious complications.This comprehensive review provides insight on various aspects of hepatolithiasis,with a focus on epidemiology,new evidence on pathophysiology,most important clinical aspects,different classification systems and contemporary management.

关 键 词：CHOLELITHIASIS Intrahepatic stones Cholangiocarcinoma Biliary parasites Recurrent pyogenic cholangitis Oriental cholangiohepatitis Hepatectomy CHOLANGIOSCOPY Liver transplant PAEDIATRIC 

分 类 号：R57[医药卫生—消化系统]