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In this editorial, we comment on the article by Ye . We specifically focused on the novel use of DynaCT biliary soft tissue reconstruction technology in the diagnosis and treatment of hepatolithiasis with bile duct stenosis, which is an innovative approach for enhancing the preoperative evaluation and surgical outcomes in hepatolithiasis. This study also highlights the limitations of conventional imaging techniques such as computed tomography and magnetic resonance cholangiopancreatography, which have low sensitivity for small stones and complex biliary strictures. Given the intricate anatomy of the biliary system and the challenges posed by limited visualization using conventional methods, DynaCT addresses these issues by providing high-resolution, three-dimensional reconstruction of the bile ducts, stones, and vascular structures, thus improving anatomical clarity and enabling precise surgical planning. We also focused specifically on the limitations of DynaCT, such as the need for specialized equipment and patient selection criteria, as well as its advantages and disadvantages compared with conventional PTOBF approaches. Overall, DynaCT represents a significant advancement in hepatolithiasis management, with the potential to become a standard imaging modality for safer and more effective biliary procedures.
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http://dx.doi.org/10.4240/wjgs.v17.i7.103492 | DOI Listing |
World J Gastrointest Surg
July 2025
Department of Surgery, School of Medical Sciences, Hospital Pakar Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia.
In this editorial, we comment on the article by Ye . We specifically focused on the novel use of DynaCT biliary soft tissue reconstruction technology in the diagnosis and treatment of hepatolithiasis with bile duct stenosis, which is an innovative approach for enhancing the preoperative evaluation and surgical outcomes in hepatolithiasis. This study also highlights the limitations of conventional imaging techniques such as computed tomography and magnetic resonance cholangiopancreatography, which have low sensitivity for small stones and complex biliary strictures.
View Article and Find Full Text PDFJ Vis Exp
June 2025
Department of Endoscopy, Shanghai Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine;
Hepatolithiasis refers to the presence of stones in the branching bile ducts above the confluence of the left and right hepatic ducts, often accompanied by extrahepatic bile duct stones. These stones can induce local infections and secondary bile duct strictures, making their discharge difficult and leading to severe complications. While endoscopic retrograde cholangiopancreatography (ERCP) is an effective minimally invasive method for treating cholangiolithiasis, it is often challenging to address hepatolithiasis using this technique.
View Article and Find Full Text PDFEndoscopy
September 2025
Department of Internal Medicine with Gastroenterology and Geriatrics, Klinik Floridsdorf, Vienna, Austria.
Quality Standards: Competence in cholangioscopy should be defined as the ability to successfully perform the procedure effectively, without trainer assistance, in 80 % of procedures. Cholangioscopy should be performed in endoscopy units with a high yearly volume of endoscopic retrograde cholangiopancreatographies (ERCPs) of all grades of complexity. Cholangiopancreatoscopy practice should be considered as standard or advanced as follows: - STANDARD : Cholangioscopy for extrahepatic biliary stones; evaluation of extrahepatic biliary strictures; selective ductal guidewire cannulation and removal of migrated biliary stents/foreign body extraction - ADVANCED : Cholangioscopy for intrahepatic biliary strictures or complex hepatolithiasis; percutaneous cholangioscopy and pancreatoscopy.
View Article and Find Full Text PDFInt J Surg Case Rep
July 2025
Hepato-pancreato-biliary Surgery Section, General Surgery Department, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Argentina. Electronic address:
Introduction: Low phospholipid-associated cholelithiasis (LPAC) syndrome is a rare biliary disorder caused by mutations in the ABCB4 gene, which encodes the MDR3 phosphatidylcholine transporter. It primarily affects young adults and may persist or recur following cholecystectomy. LPAC is characterized by intrahepatic lithiasis and recurrent biliary symptoms.
View Article and Find Full Text PDFCureus
April 2025
Department of Hepatobiliary and Pancreatic Surgery, Pontificia Universidad Católica de Chile, Santiago, CHL.
Intrahepatic hepatolithiasis, characterized by the presence of stones in the intrahepatic bile ducts, is often associated with biliary strictures and chronic inflammation, complicating surgical management. Patients with this condition frequently experience recurrent cholangitis and face a high risk of hepatic complications. Segmental laparoscopic hepatectomy is an effective therapeutic option that removes both stones and the affected liver tissue.
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