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KMID : 0352419940130040388
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Keimyung Medical Journal
1994 Volume.13 No. 4 p.388 ~ p.395
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Surgical Management of Intrahepatic Stones and Its Results
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Abstract
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Intrahepatic stones are defined as stones located proximal to the origin of the common hepatic duct. The therapeutic results have been poor because of difficulties in diagnosis and management. This condition causes serious problems including
cholangitis, obstructive jaundice and liver abscess. For resolving these problems, the operative principles are to remove all stones within the intrahepatic and extrahepatic ducts and to establish adequate drainage, especially, in case combined
with
severe stricture and dilation of the bile duct. Liver resection including the bile duct with stricuture is reported to be the best management.
The author reviewed 80 cases of intrahepatic stones who were treated surgically at Department of Surgery of Keimyung University Dongsan Medical Center for 5 years from January 1989 to December 1993.
@ES The results were as follows:
@EN 1. The incidence of intrahepatic stones was 9.6% of all gallstone patients.
2. Sex ratio of male to female was 1 : 1.8 and most prevalent age group was the 6th decade.
3. Diagnostic accuracy of each method was US 94.7%, ERCP 97.8%, PTC 100% and abdominal CT 93l.8%.
4. Operation type included bile duct drainage procedure(73.8%) and hepatectomy(26.2%).
5. The residual stone was noted in 31.3% of operation cases.
The author think the aggressive surgical treatments including hepatectomy are more effective for intrahepatic stones with bill duct stricture.
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