Biliary tree has anatomical and pathophysiological features liable to reoperation. The reoperative rate has been reported 4.1% to 25%, which is higher compared to that of Western countries. It has been suggested that the high reoperative rate in
our
country is related to the high incidence of intrahepatic duct stones, pigment stones and parasites.
To investigate clinical features of the reopertive biliary surgery, we reviewed the patients who underwent reoperation on biliary tree for benign diseases especially gallstone disease.
@ES The results are as follows;
@EN Among the 1,018 biliary operation cases. 130 reoperations (12.8%) were performed from January 1987 to December 1991.
The reasons of reoperation were recurrent stone 54.6%, remant stone 32.3% and stricture 4.6%.
The mean interval between first operation and reoperation was 7 years and 17 cases received 3 operations, 3 cases 4 operations, 1 cases 5 operations.
The ratio of reoperation according to the site of the stone in first operation were 9.1%, 22.9% and 61.7% for GB stone, CBD stone and IHD stone respectively.
The patients who underwent reoperative biliary surgery, recieved first biliary operation at younger age, had more female predominance, and higher proportion of pigment and IHD stone, compared to those who did not need reoperation. Reoperative
biliary
surgery is related to prolonged operative time, larger amount of transiusion and higher operative morbidity.
In conclusion, since reoperative biliary surgery is related to high morbidity, we should try to lower the rate of residual stone and find the measures to prevent recurrent stone and avoid operative injury possibly causing biliary stricture.
|