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KMID : 0616619990050020339
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Journal of Soonchunhyang Medical College
1999 Volume.5 No. 2 p.339 ~ p.346
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A Clinical Study of Intrahepatic Duct Stone
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Abstract
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The pathogenesis of intrahepatic cholelithiasis has an unknown etiology. The causes of gallstone formation have been suggested bile stasis due to ductal stricture, and bacterial infection and paracitic infestation of bile. The incidence of the intrahepatic cholelithiasis is higher in eastern asian country including Korea than in western countries. Variable surgical treatment modalities have been developed in past several decades. However, the treatment of intrahepatic cholelithiasis has a lot of complicated problems, because of complex intrahepatic ductal anatomy and ductal stricture.
The purpose of this study is to analyse the treatment modality of intrahepatic cholelithiasis.
46 cases of intrahepatic cholehthiasis have been analysed, who had been treated with surgery or surgery and postoperative therapeutic choledochoscopy from January 1991 for 5 years at the department of general surgery and the department of medicine, Soonchunhyang university hospital . They admitted under radiological and ultrasonographic imaging diagnosis and have been followed up for 1 to 5 years.
The results were as follows;
1. Sex ratio(male : female) was 1 : 1.2 and average age was 54 years.
2. The most common symptom was upper abdominal pain(84.8%), and the most common abnormal laboratory finding was elevated alkaline phosphatase(54.3%).
3. Intrahepatic stones were 28 cases(60.9%) in the left hepatic duct, 3 cases(6.5%) in the right hepatic duct, and 15 cases(32.6%) in the both hepatic duct. 25 cases of intrahepatic duct stones accompanied extrahepatic biliary stones.
4. Among 16 cases(34.8%) of intrahepatic ductal stenosis, follow-up study showed that 12 cases(85%) were graded as good. Among 30 cases(65.2%) without intrahepatic stenosis, 29 cases(95.8%) were graded as good.
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