|
KMID : 0371319840270060708
|
|
Journal of the Korean Surgical Society
1984 Volume.27 No. 6 p.708 ~ p.716
|
|
|
A Clinical Review of Inflammatory Biliary Tract Disease
|
|
최대식/Choi, Dae Sik
김상효/백낙환/Kim, Sang Hyo/Paik, Nak Whan
|
|
|
Abstract
|
|
|
Inflammatory biliary tract disease is one of very common surgical conditions, it, frequently accompanies gallstone, accordingly when an adequate surgical or medical management is not performed, a serious complication of jaundice, perforation or even sepsis could be developed.
Authors reviewed 224 cases of non-malignant biliary tract diseases treated with surgery during the past four years and the following results were obtained.
1) In 224 cases, acalculous cholecystitis was 52 cases (24°%), and calculous biliary diseases were 172 cases, the sex ratio of male to female was 1: 1. 2, but the incidence of acalculous cholecystitis showed higher distribution in male.
2) The overall age incidence showed a little higher prevalence in 5th decade, however, the age incidence in female was almost same in 4th and 5th decade.
3) In the clinical manifestations, almost all patient had right upper quadrant pain and tenderness, 35% of calculous cholangitis showed gross jaundice, and septic shock at the time of admission was 5 cases (2%).
4) In the analysis of liver function test, serum bilirubin was elevated in 62% of common bile duct stone, and alkaline phosphatase was elevated apparently in 70% of intrahepatic stone.
5) The anatomical locations of gallstones of 172 patients showed 45% within gallbladder alone, 22% within common bile duct alone and intrahepatic stone was 14%.
6) In Aschoff classification of gallstone, the most common type of gallbladder stone was cholesterol stone showing 48%, and main type of common bile duct and intrahepatic duct stone was calcium bilirubinate stone showing 53% and 75% respectively. Through the overall series, a relatively common stone in this institute was calcium bilirubinate stone (35%).
7) In the surgical procedures, cholecystectomy and T-tube choledochostomy was the most common operation, performing 96 cases, cholecystectomy alone was 69 cases (31%), choledo choduodenostomy was 36 cases (16%) and transduodenal sphincteroplasty was 20 cases (9%). Of 155 cases of common bile duct explorations (69%), positive finding was 118 cases (76%).
8) Postoperatively, retained stone was found in 14 cases (6%) by cholangiogram or ultra-sonogram, the treatments for this were heparin irrigation 2 cases, transduodenal sphincte-roplasty, choledochoduodenostomy, and choledochojejunostomy 1 case respectively and others are on follow-up by using oral chendoxyl.
9) In the bacteriological study of the bile, E. coli was the most common organism (46%)
and the second was Salmonella (20%).
10) Postoperative complication was developed in 11%(26 cases), among them the most common was wound infection(46%), the second was bile leakage(30%), and the overall mortality rate was 0.8%(2 cases) with cause of death hemobilia and hepatic failure.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|