[
Abstract]
[
Full Text PDF] （in Japanese / 1444KB）
[Members Only And Two Factor Auth.] J.Jpn. Surg. Soc.. 89(1): 116-121, 1988
Case report
A CASE OF PRIMARY INTRAHEPATIC CHOLESTEROL GALLSTONE DIFFICULT TO MAN AGE BY PERCUTANEOUS TRANSHEPATIC CHOLANGIOSCOPY
A case of a 60-year-old man with primary intrahepatic cholesterol gallstone was reported. Several stones, each size 3mm in diameter, were packed in the diverticulum-like dilated part of the posteriorinferior-ventral bile duct branch of the right lobe and 3 stones, each size 3－4mm in diameter, were scattered separately in the lateral segment of the left lobe of which the bile duct branches were diffusely tortuous and with mildly irregular dilatation. Morphologic appearance of the biliary system except these to areas was normal. All stones including a large gallbladder stone consisted of cholesterol. Intraluminal approach, not only ERC but also PTCS, can hardly detect intrahepatic stones of more peripheral areas, although combination of US and enhanced CT may be useful even though bile duct branches are not dilated. We failed in PTCS lithotomy in this case for the first time in our experience with more than seventy cases of intrahepatic stones. However, by PTCS it was possible to investigate
the morphology of the biliary system in detail and consequently, to make the diagnosis of primary intrahepatic stones. This patient has cured by cholecystectomy and minimum hepatectomy.
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