Laparoscopic left hepatectomy for primary intrahepatic lithiasis: surgical technique

Primary intrahepatic lithiasis (PIHL) is defined by the presence of stones that generates in the liver at the level of cystic dilatations of the intrahepatic biliary tree. When PIHL is unilateral and limited to a single hemiliver or segment, liver resection may be considered the treatment of choice, because it removes the stones together with the atrophic parenchyma with anomalous bile duct dilations and strictures, that are associated with the risk of developing cholangiocarcinoma. PIHL can represent a valid indication for the minimally invasive approach. Localized PIHL is particularly prevalent in the left lateral segment. Left hepatectomy by minimally invasive approach may be considered as a standardized procedure and an excellent choice to treat the disease, resulting in better operative results than that reported after open procedure.