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KMID : 0985520120170020001
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Korean Journal of Pancreas and Biliary Tract
2012 Volume.17 No. 2 p.1 ~ p.5
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Clinical Approach of Intrahepatic Duct Stones - Epidemiology, Clinical Manifestation & Natural Course
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Kim Dong-Uk
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Abstract
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Hepatolithiasis is a major disease in East Asia including Taiwan, China, and Korea. With the westernization of the diet and
the improvement in the quality of life, the prevalence of hepatolithiasis has been declining. However, relatively high frequency of hepatolithiasis remains unchanged in Korea, and this is thought to be related to the clonorchiasis, the traditional dietary habits, and the genetic factors. Most primary intrahepatic stones are brown-pigment stones (calcium bilirubin stones), but are likely to differ according to ethnic and environmental factors. The causes of primary intrahepatic stones are known to be high-carbohydrate, low-fat, low-protein diet, bile stasis associated with biliary strictures and anomalies, and bile infection including E. coli, Enterobacter species, and parasites. Intrahepatic stones typical present with fever, abdominal pain, and jaundice. The recurrent pyogenic cholangitis leads to liver abscess and/or secondary liver cirrhosis. Furthermore, silent cholangiocarcinoma develops in 10% of the intrahepatic stone cases even after the removal of stones, and therefore the follow-up of these cares is of clinical importance.
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KEYWORD
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hepatolithiasis, epidemiology, natural history, cholangiocarcinoma
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