J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1583KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 93(9): 1132-1134, 1992

Report on the annual meeting

SELECTION OF TREATMENT IN PRIMARY HEPATOLITHIASIS (PHL)

1) Department of Surgery, Kamigoto Hospital, Nagasaki, Japan
2) Department of Surgery, Nagasaki Chuo National Hospital, Nagasaki, Japan

Kunihisa Miyazaki1), Mitsuji Otsubo1), Takahiro Yasaka1), Masato Furukawa2), Toshiomi Kusano2)

Two hundred and three patients with PHL were encountered for the last 10 years. In order to select treatment of PHL, we classified PHL on the basis of atrophy of hepatic parenchyma (AHP), existence of extrahepatic gallstone and dilatation of extrahepatic bile duct (DEBD). For the case with AHP hepatic resection must be performed, because there is often chronic proliferating cholangitis and improvement in hepatic function can not be expected in view of AHP. For the case with extrahepatic gallstone without AHP hepatic resection. For the case with DEBD and without AHP extrahepatic gallstone must be removed. For the patient with extrahepatic gallstone and DEBD without AHP, indication of the removal of stones, depends on the existence of symptoms.
Twenty-two cases treated by biliary drainage procedure often had some complications in postoperative course, that is 5 patients had cholangitis and 7 patients liver abscess. It was suggested, therefore, that biliary drainage procedure was contraindicated in PHL.

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