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간내담석증의 임상양상과 치료선택 및 성적

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Author(s)
송완희김형수배중식박효원강구정임태진
Keimyung Author(s)
Kang, Koo JeongLim, Tae Jin
Department
Dept. of Surgery (외과학)
Journal Title
한국간담췌외과학회지
Issued Date
2000
Volume
4
Issue
2
Keyword
Intrahepatic stone
Abstract
Background : Intrahepatic stones are common in East Asia and pose serious complications such as biliary
stricture, liver atrophy, liver abscess, sepsis and sometimes cholangiocarcinoma. The management
of primary intrahepatic stones is difficult and it is also difficult to remove all stones during operation.
Methods : Eighty seven patients with hepatolithiasis were admitted to the department of surgery,
Keimyung University Dongsan Medical Center during 4 year period between 1994 and 1997. We
reviewed medical records retrospectively for these patients.
Results : The peak incidence of age was 50’s and the male to female ratio was 1:1.2. Intrahepatic
stones were located in the left lobe in 62.1%, right lobe 17.2% and both lobe 20.7%. Stones were
found only within the liver (I type) in 34.5% and both inside and outside the liver (IE type) in 65.5%.
Analysis of the composition of intrahepatic stones revealed calcium bilirubinate as the most common
compound (over 75%) and E. coli was the most common organism in bile culture. We classified intrahepatic
stones as four types. Type I (45.9%) is cases with liver atrophy on abdominal CT, type II
(20.6%) is cases without liver atrophy as IE type, type III (16.0%) is cases with dilatation of extrahepatic
bile duct as I type, and type IV (17.2%) is cases without liver atrophy nor extrahepatic bile duct dilatation.
Of the 72 operated patients, liver resection was done in 43 (59.7%) and 9 patients (20.0%) had
residual stones. Cholangiocarcinoma was found in 3 (7.0%) of the total 43 patients who underwent
liver resection.
Conclusion : Hepatic resection should be performed in selected patients with intrahepatic stones
because of lowest presence of residual stones and no difference of postoprative complications compared
with drainage procedure.
Alternative Title
Clinical Review and Surgical Treatment of Intrahepatic Stones
Keimyung Author(s)(Kor)
강구정
임태진
Publisher
School of Medicine
Citation
송완희 et al. (2000). 간내담석증의 임상양상과 치료선택 및 성적. 한국간담췌외과학회지, 4(2), 115–122.
Type
Article
ISSN
1226-4024
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/37012
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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