Tsunoda et al classified the severity of hepatolithiasis based on its anatomic features. The class can help to determine the appropriate management strategy.
Parameters:
(1) dilatation of intrahepatic bile ducts
(2) strictures of intrahepatic bile ducts
(3) laterality
Dilatation of Intrahepatic Bile Ducts
Strictures of Intrahepatic Bile Ducts
Laterality
Class
none
none
NA
I
diffuse
none
NA
II
solitary or multiple cystic dilation
present
unilateral
III
solitary or multiple cystic dilatation
present
bilateral
IV
Class
Management
I or II
choledocholithotomy or choledochojejunostomy
III
hepatic resection
IV
partial hepatic resection with bilioenteric anastomosis
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