Description

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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