Residual stones after biliary tract surgery impos a very difficult problem because of technical difficulty of removal stone and high morbidity and high mortality. We reviewed the results of the choledochoscopic stone removal of 17 patients with
residual
stones after biliary stone operation at the Seoul Red Cross Hospital from April 1992 to June 1993.
@ES The results were as follows:
@EN 1) the incidence of retained stones was 18.9% of all biliary tract operation.
2) The prevalent site of retained stones was common bile dut(52.9%). Other locations were in left hepatic duct(11.%), bilateral hepatic duct(5.9%), bilateral intrahepatic duct and common bile duct(29.4%).
3) In order to remove retained stones, toal 34 chcledochoscopic stone removal was performed. Average number of choledochoscopic stone removal was 2 times per patient(range: 1~5).
4) The complete removal of retained stones was possible in 13 cases out of total 17 cases showing 76.5% of success rate.
Particulary, the retained stones were removed completely in all of nine cases where the site of retained stones was limited to common bile duct showing 100% of success rate. Meanwhile, among 8 cases where retained stones were located other than
in
common bile duct, the removal of retained stones was possible in 2 cases where biliary stricture was not accompanied, and only 2 out of 6 cases(33.3%) where intrahepatic bile duct stricture was accompanied.
5) The causes why the removal of retained stones were not possible, but the stricture of biliary tree, the sharp angle of biliary tree made insertion of choledochoscope almost technically impossible.
6) None of the cases aeveloped any complications which required hospitalization. However, 3 cases(17.6%) showed symptoms of mild cholangitis, but those wer eimproved with antibiotics treatment.
|