A clinical review of 276 cases of biliary tract diseases which had been operated at the Dept. of Surgery, Han-II Hospital for 8 years from January 1976 to December 1983 showed the following results.
1) 276 cases of biliary tract diseases were comprised of 255 cases(92.4%) of benign diseases and 21 cases(7.6%) of malignant diseases. The most common benign disease was cholecystitis, and the most common malignant disease was bile duct cancer.
2) The sex ratio was 1: 1.4 in female predominance, and the average age was 48. 7.
3) In the duration of illiness, only 32 cases(11.6%) were operated within 1 month, and 162 cases(58.7%) within 1 year. But 114 cases(41.3%) were operated after more than 1 year of lliness.
4) The most common symptom was abdominal pain on RUQ area(73.6%). and the most common physical sign was abdominal tenderness (85.5%) on RUQ area.
5) In the biochemical study, the increased level of serum bilirubin, SGOT, SGPT, alkaline phosphatase was more valuable in the stone-bearing group than the nQn-stone bearing group, and most valuable in malignant diseases.
6) On X-ray studies, stone detection rates were 20.4% on plain abdomen, 40.0% on oral cholecystography, and 25.5% on intravenous cholangiography in stone-bearing patients. The accuracy rates were 89.1% on ultrasonography, and 100% on PTC.
7) In the distribution of stones, the total incidence of GB stones was 63.0% and of CBD stones was 48.8%, and of intrahepatic stones was 14.2%.
8) In benign diseases, the most commonly performed operative procedure was cholecyste-ctorgy and CBD exploration with T-tube drainage(65%). and the positive rate of CBD explo-ration was 58.0%. In malignant diseases, palliative operation such as cholecystoenterostomy was commonly performed, especially bile duct cancer.
9) The associated diseases were peptic ulcer(4.7%). acute pancreatitis(4.0% ), biliarycirrhosis (3.3%), D.M.(3.3%), etc.
10) In bile culture, the most commonly cultured micro-organism, was E. coli(49.3% of
cultured micro-organism).
11) The postoperative complications were wound infection(5.8%), pulmonary complications (4.3%), residual stones(3.3% ), cholangitis(2.9), etc.,
12) The operative mortality rate was 1.8%, and causes of death were septic shock (3 cases) and cardiac failure(2 cases).
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