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KMID : 0371319940460060959
Journal of the Korean Surgical Society
1994 Volume.46 No. 6 p.959 ~ p.967
A Clinical Review of Billary Stone(256 cases)
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Abstract
The clinical analysis of 256 cases who had been treated surgically for gall stone disease in National Medical Center for 3 years from January 1990 to December 1992 was done.
@ES The results were as follow.
@EN 1) The peak incidence was noted in the 6th decade and the male to female ratio was 1:49.
2) The major complaints of biliary stone was RUQ abdominal pain (62.9%).
3) The duration of symptom was within 1 month 59.4% of the patients.
4) The major positive laboratory findings were increase of alkaline phosphatase (43.8%), S-GOT(42.25), S-GPT(42.2%), SWBC count(38.3%) and total bilirubin(33.2%).
5) The ultrasonogram was done in 98.0% of the patient and its accuracy was 98.8%.
6) The location of stones was GB in 146 cases(57.0%), both CBD in 27 cases(10.5%), CBD in 26 cases(10.2%), and both GB and CBD in 24 cases(9.4%).
7) the diagnosis showed chronic cholecystitis(64.1%), suppurative cholangitis(12.9%), GB empyema(6.6^), gangrenous cholecystitis(5.9%), and acute cholecystitis(2.7%).
8) In the past, 12.9% of the patients had one time of hepato-biliary 1.2% had two times, and three times in 0.4% of the patients.
9) The most common operative procedure was cholecystectomy(55.1%), and cholecystectomy with T-tube choledochotomy was done in 31.6% of the patients.
10) The incidence of residual stone was 10.2%
11) The removal time of T-tube was within 2 weeks postoperatively in 28.7% of the patients, between 2 and 3 weeks in 33.7%, and between 3 and 4 weeks in 10.9%.
12) Bacterial cultrure was performed in 52.0% and positive culture rate was 77.4%. The major microorganisms were E. coli(35.0%), Klebsiella(35.0%), Streptocodccus(28.2%), and Pseudomonas (26.2%).
13) Most common associated diseases were, hypertension(14.1%), pulmonary tuberculosis including old inactive form(10.5%), and heart disease(5.9%).
14) In the postoperative complications, pulmonary complications including tempory postoperative atelectasis was 35.2%, wound infection was 10.9% and residual stone was 10.2%
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