48 research outputs found
Classification of Primary Hepatolithiasis According to Morphology of the Liver, Especially Atrophy of Hepatic Parenchyma
One hundred twenty one patients with primary hepatolithiasis (PHL) was encountered for the last 7 years. In order to elucidate how to follow and treat PHL, PHL was classified into five types (I-V) on the basis of morphological findings obtained by CT. It depends mainly on the presence of atrophy of hepatic parenchyma (AHP) and dilatation of intrahepatic bile ducts (DIBD). Methods of treatment were selected for each patient according to the classification. Type I patients comprised of 43.8% in observation group. These patient were asymptomatic and just followed since neither APH nor DIBD were observed. The remaining patients in the observation group, operation was refused or contraindicated. Most of them were asymptomatic. Surgical treatments were done on 47 patients (hepatic resection in 32 patients, surgical lithotomy in 10 and others in 5). In Type III, IV and V, hepatic resection was often performed to remove all of stones and bile stasis since improvement in hepatic function could not be expected in view of AHP. All patients were followed-up 79 months or less. In the surgically terated patients, recurrence was not observed. In observation group, no new symptome developed during the follow-up period. It was suggested, therefore, that the present classification of PHL was helpful in determining therapeutic strategy for PHL