A Clinical review of Biliary Tract Stone

choi, Kyoung Ju; Lee, Sang Hee

Abstract

BACKGROUND/AIMS: In Korea, the incidence and modality of gallstones has changed, since meal have become westernized and the socioeconomic status has improved. Choledocholithiasis and intrahepatic duct stone have high incidence rate in Korea and are difficult to treat as a result of retained stones. This report deals with a clinical analysis of recent trends in gallstone disease and approachs to ideal method of treatment.
METHODS
A retrospective analysis was done on 122 biliary tract stone patients who had undergone operations at the Department of Surgery, Seoul Red Cross Hospital, from July 1994 to June 2000.
RESULTS
The results are as follows 1) The male to female ratio was 1:1.7, and the most common age group were 7th decade. 2) The most common location of stones were GB and CBD in 40 cases(32.8%). 3) The most common method of operation were cholecystectomy with CBD exploration in 35 cases(28.7%). 4) The incidence of retained stones was 39.3%(48 out of 122 cases). The prevalent site of retained stones was common bile duct(23.0%). Other common locations were in CBD and left hepatic duct(11.8%), Lt. intrahepatic duct(4.1%). 5) In order to remove retained stones, total 92 choledochoscopic stone removal was performed. Average number of choledochoscopic stone removal was 2.1 times per patient(range:1-5). 6) The complete removal of retained stones was possible in 35 cases out of total 44 cases showing 79.5% of sucess rate. 7) Postoperative complication was developed in 40cases(32.8%) and the most common postoperative complications was wound infection(11.5%). The postoperative mortality rate was 4.1%.