PRIMARY INTRAHEPATIC STONES

Hepatolithiasis, or primary intrahepatic stones, is prevalent in the F ar East. This clinical syndrome has been previously referred to in the West as Oriental cholangiohepatitis. The majority of primary intrahep atic stones are calcium bilirubinate stones, but intrahepatic stones w ith high cholesterol purity have recently been recognized. Primary int rahepatic stones are formed de novo within the liver and can be distin guished from extrahepatic stones on the basis of a unique pathogenetic etiology, chemical composition, and clinical course, Patients with he patolithiasis are often plagued by a progressive illness punctuated by multiple intrahepatic strictures, recurrent cholangitis, liver absces ses, and hepatic destruction. Advances in interventional radiological techniques, cholangioscopy, and novel surgical innovations have led to significant changes in the way these patients are now managed.