Long-term results of surgical treatment for intrahepatic stones |
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Authors: | Tsukasa Tsunoda MD Ryoichi Tsuchiya Noboru Harada Ryozo Yoshino Takatoshi Noda Kunihide Izawa Takashi Yamaguchi Kensuke Yamamoto |
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Institution: | (1) The Second Department of Surgery, Nagasaki University School of Medicine, 852 Nagasaki, Japan |
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Abstract: | One hundred and nineteen patients with intrahepatic stones treated surgically in Nagasaki University Hospital from 1969 to
1984 were reviewed. The patients were divided into four types according to location of the stones and the presence or absence
of stenotic lesions and/or localized dilatation of the intrahepatic bile ducts. Types I and II patients were treated with
choledocholithotomy or choledochojejunostomy, while type III patients underwent hepatic resection and type IV patients were
treated by partial hepatic resection with bilioenteric anastomosis, including extended hepaticocholedochojejunostomy. The
majority of operative or early deaths belonged to type IV and residual stones were present in almost all patients. The longterm
results for the 88 patients revealed that the rate of improvement was 100 per cent for type I, 87 per cent for type II, 83
per cent for type III and 84 per cent for type IV. In type IV, the most excellent results (92 per cent) were obtained by extended
hepaticocholedochojejunostomy, especially with hepatectomy. It is suggested that extended hepaticocholedochojejunostomy with
partial hepatic resection is a reasonable procedure for treating patients with type IV intrahepatic stones. |
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Keywords: | primary and secondary intrahepatic stones extended hepaticocholedochojejunostomy hepatic resection |
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