총수담관 절개 및 T-관 삽입을 시행한 담도계 질환

Abstract

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 available) 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.