Hepatolithiasis with Stricture in the Left Hepatic Duct, Report of a Case T. Ichihara 1 , K. Goto 2 , K. Hayashi 3 , N Goto 4 , T. Takeuehi 4 1Department of Surgery, Gifu Prefectural Tajimi Hospital 2Department of Gastroenterology, Gifu Prefectural Tajimi Hospital 3Department of Pathology, Gifu Prefectural Tajimi Hospital 4The First Department of Internal Medicine, Nagoya City University, School of Medicne pp.463-466
Published Date 1984/4/25
DOI https://doi.org/10.11477/mf.1403107012
  • Abstract
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 A 58 year-old woman was admitted to our hospital with a chief complaint of high fever and pain in the right hypochondrium. With ultrasonic-guided PTC a diagnosis of primary hepatolithiasis with stricture in the left hepatic duct was made (Fig. 1).

 Recent progress of medical technology has enabled us to easily diagnose this disease. Ultrasonic-guided PTC is very effective especially when, owing to stricture, the hepatic duct cannot be sufficiently delineated.  The patient has made favorable progress after she underwent left hepatectomy including the strictured area (Fig. 2). We made a pathological examination of the strictured area of the resected liver and explored the pathogenesis of this disease. We found that, histologically, the strictured area was similar to the wall of the bile duct. We presume that a congenital septum of the bile duct causes cholestasis and lithogenesis, resulting in repeated chronic cholangitis, which in turn causes hypertrophic stenosis (Figs. 3-6).  In conclusion, we are convinced that hepatectomy including the strictured area is the most ideal therapy for this disease.

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