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KMID : 0614619930250010140
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Korean Journal of Gastroenterology
1993 Volume.25 No. 1 p.140 ~ p.150
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Cholangiographic Features in Hepatolithiasis
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Abstract
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Cholangiography plays a key role in the diagnosis and the treatment of hepatolithiasis. The purposes of this study are to determine the characteristics of cholangiographic feature in hepatolithiasis, to find whether there is any clinical
significance of
a classification (primary vs secondary) based on cholangiographic findings and whether anatomical variation of bile duct can be an etiologic factor for hepatolithiasis. We analyzed 100 cases of hepatolithiasis treated in the Department of
Surgery,
Seoul
National University Hospital during recent 5 years. Using nakayama's classification. We also classified them into primary hepatolithiasis (arising in the liver) and secondary hepatolithiasis (secondary to changes in the extrahepatic duct) to
compare
clinical features and outcome. Anatomic variation of the hepatic duct confluence of these cases were compared to that of 100 control cases without hepatolithiasis.
@ES The results are as follows:
@EN Intrahepatic calculi were more prevalent in the left lobe (L+LR:R+LR=5:3) and intra and extrahepatic type (IE) was more frequent in 2.8 fold than intrahepatic type (I). There were 159 strictures in 88 patients and 213 dilatations in 95
patients
Prinary hepatolithiasis developed relatively in younger age group and the location of stones. Stricture and dilatation of bile ducts were more prevalent in left side. Secondary hepatolithiasis seems to be associated with more severe symptom and
frequent
laboratory abnormalities. However, in terms of treatment outcome, no difference was noted between the two groups. Bile duct anomalies were p(?)sent in 17 cases of hepatolithiasis group and 16 cases of control group. Thus anatomic variations in
the
main
intrahe. Patic bile ducts do not seem to be associated with hepatolithiasis, and their etiologic significance seems to be unlikely.
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