Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

A Study of Factors Related to Recurrent Stones after Surgical Treatment of Hepatolithiasis

간내 담석 수술 후 재발에 영향을 미치는 인자에 대한 연구

  • Bae, Sang-In (Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Yu, Hee-Chul (Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Cho, Baik-Hwan (Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School)
  • 배상인 (전북대학교 의학전문대학원 외과학교실 및 임상의학연구소) ;
  • 유희철 (전북대학교 의학전문대학원 외과학교실 및 임상의학연구소) ;
  • 조백환 (전북대학교 의학전문대학원 외과학교실 및 임상의학연구소)
  • Published : 2010.06.30
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Abstract

Purpose: Hepatolithiasis, which is located in proximal sites of the common hepatic bile duct, is a common disease in Korea. Hepatectomy is a more effective treatment for achieving complete removal of stones and biliary strictures. However, the incidence of remnant or recurrent stones is still high. The aim of this study was to evaluate factors related to the recurrence of stones after surgical treatment of hepatolithiasis. Methods: From February 1999 to February 2009, we conducted a retrospective study of case records of 208 patients who underwent operations for hepatolithiasis at the Department of Surgery, Chonbuk National University Hospital. Results: The male to female ratio was 1:1.97; the mean age was 55 years. Hepatolithiasis was located in the left intrahepatic duct in 69.7% of patients, in the right intrahepatic duct in 14.4%, and in both ducts in 15.9%. Operative procedures were as follows: left lateral sectionectomy in 109 (52.4%), left hemihepatectomy in 26 (12.5%), posterior sectionectomy in 5 (2.4%), a right hemihepatectomy in 8 (3.8%), a choledocholithotomy in 38 (8.6%), a choledocho-enterostomy in 18 (8.6%), a choledochotomy in 1 (0.46%), a choledochal cyst excision in 1 (0.46%), and no primary operation in 2 (0.9%). Complete stone clearance was achieved in 76% after operative treatment. Biliary stricture was significantly associated with remnant stones (p=0.000). In addition, the incidence of recurrent stones was 15.3%. Recurrent stones were associated with biliary stricture (p=0.001), hepatectomy (p=0.003), and bilateral location of stones (p=0.016). During the follow up period, the mortality rate related to operative treatment was 0.96%. Conclusion: Biliary stricture, hepatectomy, and bilateral location of stones are associated with recurrent hepatolithiasis after surgery.

Keywords

References

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