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KMID : 0371319690110120785
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Journal of the Korean Surgical Society
1969 Volume.11 No. 12 p.785 ~ p.794
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Clinical Studies on Non-malignant Biliary Taract Diseases
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洪善憙/Hong, Sun Hee
金正萬/張秀一/朴雨春/朴利玖/李東植/Kim, Jung Man/Chang, Soo Il/Park, Rhee Koo/Park, Oo Choon/Lee, Dong Sik
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Abstract
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The clinical records of 231 patients who were operated upon non-malignant biliary tract diseases, during last 6½ years up to August 1968, have been analyzed and the results were summarized as follows:
1. Among 231 patients, 155 cases (67.0%) had cholelithiasis with acute or chronic cholecystitis and 23 cases were cholecystitis without stone. And also noted biliary ascariasis in 29 patients(12.9%), perforation of the gallbladder in 12 patients (5.1%), empyema of the gallbladder in 5 cases (2.1%) and congenital biliary tract anomalies in 7 cases (3.0%)
2. Of 155 patients with cholelithiasis, 109 patients (70.4%) were found to have stone or stones in the common pile duct, 70 cases (45.1%) in the gallbladder, 12 cases (8.8%) in the intrahepatic duct and 6 cases (3.8%) in the hepatic duct.
3. The highest incidence of disease was in 4th decade of life and there was no significant difference in the incidence between male and female.
4. The main clinical symptoms and physical findings were as following orders; pain in the R.U.Q. (93.3%), indigestion (60.8%), radiating pain(42.5%), fever and chills(38.7%), nausea and vomiting(37.6%) and tenderness in the upper abdomen(70.4%), muscular rigidity(59.0%), hepatomegaly(28.6%)and jaundice(26.9%).
5. The hemogram showed no remarkable changes except mild leukocytosis (64.0% of examined group). A significant change in liver profile were elevated alkaline phosphatase (60.4% of examined cases), elevated serum bilirubin especially direct bilirubin (34.2%), and increased B.S.P. retention (28.8%).
6. On plain X-ray films of the abdomen in 163 cases gallstone were defected with the rete of 6.7%(11 case). 86.1% of 72 oral cholecytograms and 65.8% of I.V. cholangiograme performed in 44 cases were found to be abnormal.
7. The most commonly performed onerative procedure was the cholecystectomy with coholedochostomy(74.4%) Among 179 common duct explorations, 138 cases (77.0%) showed positive findings which revealed gallstones, ascriasis and/or other pathology.
8. The post-operative complications occurred in 25 patients(9.0%), of which residual stones(8 cases)were the most comom.
9. The operative mortality for the entire group was 3.4% (8 cases).
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