Etiology of Hepatolithiasis: A Tertiary Care Center Based Observation in Bangladesh
Bibliographic record
Abstract
Background: Hepatolithiasis is a complex hepatobiliary disorder characterized by intrahepatic bile duct stone formation with high recurrence and risk of severe complications. Its etiological profile varies geographically, with infectious, parasitic, and structural causes playing a dominant role in developing countries such as Bangladesh. However, local data remains limited. This study is aimed to evaluate the etiological factors associated with hepatolithiasis in patients managed at a tertiary care center in Bangladesh. Methods: This descriptive cross-sectional study was conducted in the Department of Hepatobiliary, Pancreatic and Liver Surgery, a tertiary care center, from January 2022 to July 2025. A total of 52 patients with radiologically confirmed hepatolithiasis were included. Clinical, demographic, laboratory, radiological, and available microbiological data were analyzed to determine underlying etiological factors. Results: The mean age of patients was 49.8 ± 11.6 years, with a male predominance (57.7%). Recurrent right upper abdominal pain (88.5%) was the most common symptom. Infection-related factors were identified in 73.1% of cases, making them the leading etiological association. Biliary strictures were present in 36.5% and suspected parasitic infestation in 23.1% of patients. Structural abnormalities such as choledochal cysts and postoperative biliary injuries were also noted. Left hepatic duct involvement was most common (51.9%). Enteric organisms, mainly Escherichia coli and Klebsiella pneumoniae, were identified in available cultures. Most patients had multifactorial etiologies. Conclusion: Hepatolithiasis in Bangladesh is predominantly driven by recurrent biliary infection, biliary strictures, and parasitic infestation, often in combination. The disease commonly presents late with advanced biliary changes. Early recognition, correction of underlying biliary pathology, and prevention of infection and parasitic disease are essential to reduce recurrence and complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".