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J.Jpn. Surg. Soc.. 85(9): 1098-1102, 1984
Report on the annual meeting
INFECTED BILE AND INTRAHEPATIC GALLSTONES
Currently, the incidence of the upper stenotic type and intrahepatic stenotic type have been increasing in number. These changes may be attributed to the improvements of the diagnostic tools for hepatobiliary diseases, especially in the progress of imaging methods. In view of the type of gallstone, most intrahepatic gallstones are the calcium bilirubinate stones generated on the basis of bile stasis and bacterial infection. For the formation of calcium bilirubinate stones the murual relationship of bacterial β-glucuronidase and glucaro-1, 4-lactone in the bile is thought to important. Free bile acids and fatty acids are detected in fairly large amount in calcium bilirubinate stones. This suggests that precipitation of calcium bilirubinate in the bile may coincidently occur with the deconjugation of the conjugated bile acids and decomposition of lecithine. In the formation of calcium bilirubinate stones, it is believed that diet and bacterial infection accompaning biliary stasis are important inducements. Scince these stones are formed mainly in bile ducts and recurrence rates are likely to high, it is imprortant to remove these inducements from therapoitic viewpoint.
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