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KMID : 0371319840260030349
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Journal of the Korean Surgical Society
1984 Volume.26 No. 3 p.349 ~ p.356
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A Clinical Study of Primary Operative Procedures in Common Bile Duct Stones
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박웅채/Park, Ung Chae
이한식/권순대/최원철/Lee, Han Sik/Kwon, Soon Dae/Choi, Woon Cheal
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Abstract
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The present study is a clinical observation and review of our recent exjerier.ces for 1C5 common bile duct stones at Incheon Christan Hospital during last 5 years up to April, 1983.
The purpose of this article is to evaluate the reasonable surgical procedure for common bile duct stones at the first operation.
Following results were obtained.
1) The incidence of common bile duct stones among biliary stone patients was 51%
2) The peak incidence of age was the 4th decade and the male to female ratio was 1:1.8.
3) Our popular diagnostic method for the useful Ecreening test was ultrasonogram and this showed the highest accuracy with 93. 5% sensitivity and 90. 3% specificity.
4) 81% cases of common duct stones were above. 5 cm in their external diameter.
5) The most common category of number in common duct stoneswas multiple stones(43.8%) and most cases of stones were located in the CBD only(41.0%).
6) Primary operative procedures were cholecystectomy with T?tube choledochostomy(47.6%), choledochoduodenostomy(32.4%), choledochojejunostomy with Roux-en-Y, sphincteroplasty, left lateral segmentectomy with choledochoduodenostomy and Longmire procedures.
7) After primary operation, residual stones were occurred in 15.9%. After T?tube choledochostomy, recurrence rate of residual stone was 26% and after choledochoduodenostomy, it was only 7.1%.
8) Postoperative complications were developed in 38% cases of T?tube choledochostomy and 14.7% cases of choledochoduodenostomy. Over all complication were 27.6%
9) According to this clinical study, we could conclude that choledochoduodenostomy had significant advantages as a primary procedure, when the external diameter of common duct was at least 1.5 cm.
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