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World J Gastroenterol. Dec 28, 2015; 21(48): 13418-13431
Published online Dec 28, 2015. doi: 10.3748/wjg.v21.i48.13418
Hepatolithiasis and intrahepatic cholangiocarcinoma: A review
Hyo Jung Kim, Jae Seon Kim, Moon Kyung Joo, Beom Jae Lee, Ji Hoon Kim, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young-Tae Bak
Hyo Jung Kim, Jae Seon Kim, Moon Kyung Joo, Beom Jae Lee, Ji Hoon Kim, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young-Tae Bak, Department of Internal Medicine, Korea University college of Medicine, Guro Hospital, Seoul 152-703, South Korea
Author contributions: Kim JS conceived and designed the review; Joo MK, Kim JH, Yeon JE and Park JJ acquired subjects and data; Byun KS and Bak YT interpreted the data; Kim HJ and Kim JS wrote the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jae Seon Kim, MD, PhD, Department of Internal Medicine, Korea University college of Medicine, Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 152-703, South Korea. kimjs@kumc.or.kr
Telephone: +82-2-26261770 Fax: +82-505-1151778
Received: June 28, 2015
Peer-review started: July 2, 2015
First decision: July 20, 2015
Revised: August 11, 2015
Accepted: September 28, 2015
Article in press: September 30, 2015
Published online: December 28, 2015
Abstract

Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis is an established risk factor for cholangiocarcinoma (CCA), and chronic proliferative inflammation may be involved in biliary carcinogenesis and in inducing the upregulation of cell-proliferating factors. With the use of advanced imaging modalities, there has been much improvement in the management of hepatolithiasis and the diagnosis of hepatolithiasis-associated CCA (HL-CCA). However, there are many problems in managing the strictures in hepatolithiasis and differentiating them from infiltrating types of CCA. Surgical resection is recommended in cases of single lobe hepatolithiasis with atrophy, uncontrolled stricture, symptom duration of more than 10 years, and long history of biliary-enteric anastomosis. Even after resection, patients should be followed with caution for development of HL-CCA, because HL-CCA is an independent prognostic factor for survival. It is not yet clear whether hepatic resection can reduce the occurrence of subsequent HL-CCA. Furthermore, there are no consistent findings regarding prediction of subsequent HL-CCA in patients with hepatolithiasis. In the management of hepatolithiasis, important factors are the reduction of recurrence of cholangitis and suspicion of unrecognized HL-CCA.

Keywords: Cholangiocarcinoma, Hepatolithiasis, Intrahepatic, Management

Core tip: In this study, we review recent studies on hepatolithiasis and discuss hepatolithiasis-associated cholangiocarcinoma (HL-CCA). Management of hepatolithiasis requires proper treatment to reduce recurrence and achieve early detection of HL-CCA. It is not clear whether hepatic resection can reduce the occurrence of HL-CCA, and there is no surveillance tool to predict subsequent occurrence. Patients should be followed after treatment because there are no effective measures to prevent HL-CCA and premalignant lesions.