Intrahepatic Duct Stones in Young Patients

Han, Ho Seong; Kim, Young Woo; Choi, Yong Man

Abstract

PURPOSE: The etiology of intrahepatic duct stone has not yet been elucidated. This disease is more prevalent in older patients, but it can occur in young patient, too. The study of intrahepatic duct stones in young patients may provide clues to the pathogenesis of this disease.
METHODS
We analyzed the anatomic distribution of stones and the presence of ductal strictures, as well as the operative methods and the results of treatment. We treated 125 patients with intrahepatic duct stones, of which 15 patients were under 40 years of age and 110 patients were over 40.
RESULTS
The average age was 32.9 in young patients and 58.4 in older patients. The anatomic distributions of stones in young patients were even between the right and the left lobes, 4 in the right lobe, 8 in both lobes and 3 in the left lobe. However, the distributions in older patients showed predominance in the left lobe, 61 in the left lobe, 31 in both lobes and 18 in the right lobe. Strictures of duct were present in 7 (46.7%) patients in the young group and 35 (31.8%) in the older group. Hepatic resections were done in 7 (46.7%) and 35 (52.7%) in young and older patients, respectively. The incidence of remnant stones was similar between the two group, 40% in young patients and 31.8% in older ones. The complication rate was less in young patients (6.7%) than in older patients (24.5%).
CONCLUSION
Intrahepatic duct stones in young patients had a tendency to develop in the right lobe and to have strictures in the duct. More aggressive treatment is recommended for this group of patients.