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KMID : 0371320010610040406
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Journal of the Korean Surgical Society
2001 Volume.61 No. 4 p.406 ~ p.414
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Classification of Intrahepatic Duct Stones and Analysis of Operation Methods
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Bae Yong-Deuk
Kim Jae-Hong
Kwon Dae-Seong
Lee Seung-Bae
Park Joo-Seok
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Abstract
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Purpose : Intrahepatic duct stones have been known to be a benign disease but because of the associated serious complications and the high recurrence rate, the management of the hepatolithiasis is very difficult. This purpose of this study
was to
classify the patterns of intrahepatic duct stones, and to evaluate the effect of surgical treatment according to their type and the residual stones that were present.
Methods : The clinical records of 212 patients who underwent a hepatic resection or drainage procedures between January 1988 and December 2000 were reviewed.
Results : We classified the intrahepatic duct stones as being either a localized simple type, a localized complicated type, a diffuse simple type, or a diffuse complicated type. Hepatic resections were performed in 177 (83.5%) cases. Among
these
we performed a hepatic resection along with drainage procedures in 41 cases (19.3%). In 35 (16.5%) cases, only drainage procedures were performed. Of a total of 25 cases of postoperative residual stones (25 cases), 13 (52%) cases were removed
completely
or partially by choledochoscopic procedures in 13 (52%) cases and in 15 (60.0%) cases they were removed completely or partially by spontaneous drainages.
Conclusion : Our conclusions were that the, localized type of the IHD stones were treated successfully by a hepatic resection and the localized complicated type and the diffuse type IHD stones were treated effectively by hepatic resection
and
drainage procedures which reduced the opportunity for residual stones to develop following an accurate preoperative diagnosis of the location of the stones. Therefore, treatment methods should be individualized for each type of stone and by
surgical
treatments that combine endoscopic and resolution methods.
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KEYWORD
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