Intrahepatic bile duct stone is a common disease in biliary tract surgery.The treatment is complex,and the recurrence rate is high.In general,the stones are difficult to be completely removed during bile duct exploration.In addition,the intrahepatic bile duct stenosis or cystic dilatation is unable to be processed and stone recurrence rate is high.Recently,the liver segment and the hepatic lobe resection are widely applied in clinic,which is helpful to remove the stones and remove abnormal bile duct and liver tissue as well.However,for the bilateral diffuse hepatolithiasis undergone resection,it often requires multiple regular hepatic lobectomies.So that,more liver tissues are lost,higher risk of postoperative liver failure.Therefore,there is a controversial for hepatic lobectomy in those patients.There is a novel treatment approach to remove the stone through fibrocholedochoscopy after minimally invasive percutaneous transhepatic biliary drainage (PTCD) for those patients.The procedure has small trauma and could be repeated.Therefore,patients with intrahepatic bile duct stones should be targeted to adopt an individualized treatment plan after accurate preoperative evaluation.%肝内胆管结石是胆道外科的常见疾病,治疗复杂,且复发率高.胆管切开取石,结石很难彻底取净,且肝内狭窄及囊状扩张的胆管无法处理,结石复发率高.近年来,肝段、肝叶切除广泛应用于临床,有助于取净结石、同时一并去除病变的胆管及肝组织,具有结石残留率低、复发率低的突出优势.但对于双侧弥漫性肝胆管结石病,常常需要施行多处规则性肝叶切除,功能肝组织丢失较多,术后发生肝功能衰竭的机会增加,对于此类患者是否规则肝切除存在争议,微创经皮胆管穿刺引流(PTCD),再进行胆道镜取石,因创伤小,可反复操作,对此类患者不失为一种新的治疗手段.因此,肝内胆管结石的患者应在精确的术前评估后针对性地制定个体化的治疗方案.
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