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KMID : 0371319720140010033
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Journal of the Korean Surgical Society
1972 Volume.14 No. 1 p.33 ~ p.37
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A Clinical Study of Intrahepatic Gall Stones
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南錫株/Nam, Suk Ju
朴南奎/徐廷旭/李東植/Park, Nam Kiu/Suh, Jung Wook/Lee, Dong Sik
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Abstract
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The intrahepatic biliary stone is more common among oriental population than European and presents
many annoying problems with unfavorable complications such as liver ascess, persistent cholangitis, biliary
cirrhosis and continuing biliary obstruction.
We experienced 42 cases of intrahepatic stonses in 148 cases operated for biliary stones from January
1966 to June 1971.
All intrahepatic stones was bilirubin stones and 83% of the intrahepatic stones became residual stones.
A lightly higher incidence was noted in males than in females.
The peak age incidence was between the ages of 20 and 40.
We noted three mummified ascaries in the intrahepatic ducts and bilirubin precipitated aroun and on
them so that the ascaries seemed to be causes of intrehepatic gall stones.
Operative cholangiograms seem to be most valuable in diagnosing intrahepatic stones and endoscopy and
ultrasonic probe are considered other valuable ancillary methods.
Complete removal of intrahepatic stones woth ordinary surgical precedure was only 17 percent.
The most frequently performed operative procedure for residual intrahepatic stones was choledochoen
terostomy, mainly choledochojejunostomy.
Choledochduodenostomy is thought to be more physiologic than choledochojejunostomy.
Benzalkonium chloride solution was used for irrigation of the biliary tree through a T-tube in order
to resolve residual stones, however, its effect was not satisfactory for bilirubin stones but considered as
an effective ancillary procedure for surgery.
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