총수담관 절개 및 T-관 삽입을 시행한 담도계 질환
A Study of Obstructive Biliary Tract Diseases in 307 CBD Exploration Cases

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서울대학교 의과대학
Seoul J Med 1984;25(4):557-568
From a study of 307 patients who underwent operation
(CBD exploration and T-tube choledochostomy),
from January 1978 to December 1982, we found the
following results:
1. From the analysis of 307 patients , we found
that 226 cases (73. 6%) were biliary tract stones, 27
cases (8.8%) were parasites , 33 cases 00.7%) were
malignancies, 21 cases (6.8%) were benign strictures
without stones.
2. Biliary tract stones
1) The ratio between gallbladder stones and CBD
stones is 61: 128.
2) Intrahepatic stones are detected in 16.4% of the
cases. Left hepatic duct stones were 16 cases, right
duct stones were 10 cases and both hepatic duct stones
were 11 cases. Twenty one cases out of 34 cases with
intrahepatic stones were diagnosed during operation
(esp. operative cholangiogram). After surgery, T-tube
cholangiographic findings revealed that 24 out of 34
cases remained stones
They had immense problems in operative managements
which may be required aggressive surgical rna-
3. Chledochal helminthiasis was seen in 8.8% of
the cases. All were accompanied by nausea and vomit·
ing, and clinical history was longer than that of stones.
77.8% of the cases had coexisting stones in
biliary tract
4. Bilirubin and alkaline phosphatase values before
and after surgery. (We collected 178 cases out of 307
CBD exploration of which liver function test were
a. Bilirubin
1) Serum bilirubin concentrations were increased in
143 cases (80.3%) of 178 cases.
2) Within 6 weeks of operation serum bilirubin
returned to normal in 158 cases (89%) of 178 cases.
3) Jaundice more than 4 weeks before operation,
bilirubin values greater than 10mg/l00ml indicated a
lower than average chance of postoperative resolution
of jaundice.
4) The preoperative peak level of the alkaline phosphatase
was no correlation with postoperative normalization
of the bilirubin level.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 25 No.4 (1984)
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