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Stones in the Intrahepatic Ducts

Arch Surg. 1965;91(3):474-477. doi:10.1001/archsurg.1965.01320150104018.
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INTRAHEPATIC gallstones are relatively uncommon. Most of them are readily removed with careful manipulation of a common duct scoop, although great care must be utilized lest they be pushed upward into the liver where they may become impacted. This happened once to the senior author (W. H. C.); during the operation a stone was accidentally pushed upward into the liver from which area it could not be displaced. For 20 to 30 minutes we tried unsuccessfully to dislodge it. We chose not to mutilate the liver in an attempt to extract it, but assumed that if we would terminate the operation and allow routine ambulation postoperatively the stone would drop down into the common duct from which location it could be extracted. True enough, 12 days after operation a cholangiogram revealed it had dropped down. Accordingly, a few days later, we reoperated on the patient and removed the stone.



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