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Invited Critique
June 16, 2008

Liver Resection for Primary Intrahepatic Stones—Invited Critique

Arch Surg. 2008;143(6):574. doi:10.1001/archsurg.143.6.574

Nuzzo and colleagues describe an interesting series of 35 patients with intrahepatic lithiasis who underwent exploration at a single institution during a 13-year period. Presentation and management of intrahepatic biliary stones is well reported in the Eastern literature, but the disease is very rare in Western countries, from where this article comes. This series nicely complements smaller series reported by Herman et al,1 Vetrone et al,2 and Di Carlo et al3 that represent the bulk of reports from Western countries. Nuzzo and colleagues successfully resected the involved liver segments in 34 of the patients (1 patient had unresectable cholangiocarcinoma). They report very acceptable mortality and morbidity rates of 0.0% and 20.0%, respectively, and good long-term results in patients with long-term follow-up. Of note, 3 of the 35 patients (8.6%) in their series had cholangiocarcinoma.