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KMID : 0870419970010020025
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1997 Volume.1 No. 2 p.25 ~ p.31
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Surgical Management of Hepatolithiasis
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Kim Sun-Whe
Park Yong-Hyun
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Abstract
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Aims ＆ Method Over a 5-year period(’91-’95), experiences of hepatolithiasis in our department were reviewed and the results were compared with two of our previous reports(’81-’85 ＆ ’86-’90) to determine whether any changing trends existed in terms of type of surgery and stone clearance rate.
Results As a type of primary operation for hepatolithiasis, biliary drainage operation has decreased and liver resection has increased. Choledocho- or hepaticojejunostomy has become a standard biliary drainage procedure, whereas choledochoduodenostomy and sphincteroplasty have almost been abandoned. Operative stone clearance rate has not changed, but success rate of postoperative lithotripsy has improved. Recurrent stone was detected in 16 patients among our most recent 5-year cases and 6 of them were detected within 2 years after Clearance. Hepatolithiasis-associated cholangiocarcinoma was found in 14 patients and only 4 of them were removed surgically. Interval between diagnosis of hepatolithiasis and cholangiocarcinoma was up from several years to 10 years in 5 cases. The stone location was different from tumor location in 4 case.
Conclusion It is suggested that hepatolithiasis is associated with cholangiocarcinoma and the risk of tumor persists even after stone removal. Therefore, longterm follow-up of patients with previous or current hepatolithiasis is needed because of recurrence, biliary cirrhosis and cholangiocarcinoma.
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KEYWORD
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hepatolithiasis, cholangiocarcinoma, hepatectomy
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