DOI: 10.25881/20728255_2021_16_4_46


Ruziboyzoda K.R., Gulzoda M.K., Safarov B.I.

Avicenna Tajik State Medical University, Dushanbe, Tajikistan


Purpose. Improving the diagnosis and surgical treatment of hepatolithiasis.

Material and methods. The results of complex diagnostics and treatment of 34 patients with hepatolithiasis over the last 10 years have been analyzed. In 31 (91.2%) cases, there was a secondary «western» type of hepatolithiasis, in 3 (8.8%) cases — a primary «eastern» type of the disease. The etiological causes of secondary hepatolithiasis in 18 (52.9%) cases were high strictures of the bile ducts and formed hepaticojejunoanastomoses. In 5 cases choledocholithiasis was diagnosed with spread to the intrahepatic bile ducts, in 4 (11.8%) cases hepatolithiasis developed on the basis of cholestasis and strictures of ectazed intrahepatic bile ducts in Carroli’s disease (n = 2) and opistochorous stricture of segmental bile ducts. In 4 more cases it was not possible to establish the etiological factors of hepatolithiasis.

Results. For the correction of hepatolithiasis in their observations, open traditional surgical interventions were applicable in 26 cases with performing resection and reconstructive-restorative surgical interventions of various nature and volume. In the postoperative period, 13 (38.2%) septic complications with 1 (2.9%) death were observed. Minimally invasive interventions were performed in 8 cases with secondary hepatolithiasis using antegrade and retrograde methods, both restoring the outflow of bile in the area of posttraumatic, postischemic, inflammatory biliary stricture, hepaticojejunostomy stricture, and destroying calculi (lithoextraction). In 2 cases, there were so-called «minor» complications in the form of migration of cholangiostomy drainage. There were no deaths.

Conclusion. Thus, in the treatment of hepatolithiasis, a personalized approach is the most effective, it allows in each case to choose the most pathogenetically justified method of treatment.

Keywords: diagnostics, hepatolithiasis, obstructive jaundice, surgical tactics.


1. Lomakin IA, Ivanov YuV, Sazonov DV. Diagnostics and treatment tactics in patients with obstructive jaundice. Clinical practice. 2012; 3: 42-50. (In Russ).

2. Shao JH, Fang HX, Li GW. Percutaneous transhepatic biliary drainage and stenting for malignant obstructive jaundice: A report of two cases. ExpTher Med. 2015; 10(4): 1503-1506.

3. Yu H, Wu S, Yu X. Single-incision laparoscopic biliary bypass for malignant obstructive jaundice. JGastrointest Surg. 2015; 19(6): 1132-8.

4. Malkov IS, Shaimardanov RSh, Korobkov VN. Factors influencing the results of treatment of patients with obstructive jaundice. Surgery. Journal them. N.I. Pirogov. 2016; 10: 48-51. (In Russ).

5. Nazirboev KR, Kurbonov KM. Ways to improve the results of surgical treatment of obstructive jaundice of benign genesis. Bulletin of the National Medical and Surgical Center. N.I. Pirogov. 2017; 12(4-2): 52-55. (In Russ).

6. Xu C, Lv PH, Huang XE. Internal-external percutaneous transhepatic biliary drainage for patients with malignant obstructive jaundice. Asian Pac J Cancer Prev. 2014; 15(21): 9391-4.

7. Alikhanov RB, Vishnevsky VA. Intrahepatic lithiasis. Annals of Surgical Hepatology. 2008; 2: 100-104. (In Russ).

8. Dzhorabekov AD, Alapaev ASh, Ismailov ASh. Surgical tactics for intrahepatic and extrahepatic cholangiolithiasis. Annals of Surgical Hepatology. 2006; 4: 39-42. (In Russ).

9. Brashnikova NA, Tsloy VF, Merzlikin NV, Lyzko IA. Intrahepatic lithiasis. Annals of surgery. 2014;1: 39-41. (In Russ).

For citation

Ruziboyzoda K.R., Gulzoda M.K., Safarov B.I. Diagnostics and surgical tactics for hepatolithiasis. Bulletin of Pirogov National Medical & Surgical Center. 2021;4(16):46-50. (In Russ.)