Intrahepatic stone was a disease that was found predominantly in South-East Asia. This conditio causes serious problems including cholangitis, obstructive jaundice and liver abscess.
For resolving this problems, the operative principles were to remove all stones within the intrahepatic ad extrahepatic ducts and to establish adquate drainage.
We reviewed 67 patients with intrahepatic stones who were treated surgically at Depatent of General Surgery of Maryknoll Hospital for 4 years from August 1988 to July 1992. During this period, the incidence of the intrahepatic duct stone was 63
cases(11%) among 572 cases in the biliary tract stones. The male to female ratio was 1 : 1.52. The most prominent symptom and sign were RUQ pain and tenderness. In the distribution of stones, the incidence of LR-type, L-type, and R-type were 46%,
35%
and 19% respectively. The 43 cases of bile cultures result in positve and the majority were E. coli(70%), Klebsiella and pseudomonas in orders. In order to compare results, all patients were divided into 3 groups(Group I: choledochotomy with
lithotomy,
Group II: drainage grocedures, Group III: hepatic resection with/without drainage procedures). The cholangiocarcinoma was associated with cases; one cases in Group III, two cases in Group I. The incidence of residual stone was 36.3% in Group I,
77.5% in
Group II and 33.3% in Group III. Follow up study for 6 months to 4 years showed good results 66.7% in Group I, 81% in Group II and 83% in Group III.
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