8. 간엽부분 절제술은 8예에서 시행하였고 이 중 6예에서 Longmire술식을 시행하였다,
9. 사망예는 7예 ( 6% )이었으며 이는 모두 좌우 양측 간내담석으로 다발성협착이 있었던 환자이었다.
10. 간좌엽에 국한된 병소가 심한 간내담석증이 있을때 간좌엽 혹은 간엽절제술 같은 보다 적극적인 수술방법이 좋을 것으로 생각된다.
[영문]
During the past 10 years beginning from January, 1970 to December, 1979, 161 patients of the intrahepatic lithiasis were operated at the department of General Surgery, Yonsei University Medical College. Among the 161 patients. clinical analysis was performed on 118 patients. Forty three patients were not included in this study because of insufficient data.
Even though incidence of the intrahepatic lithiasis seemed to decrease gradually in Japan, that in Korea was still high. Of 1,099 gallstone cutes surgically treated, 161 were associated with intrahepatic calculi, an incidence of 15 per cent. The peak incidence occurred in the 20 to 30 years age range. Mast of the patients were in low socioeconomic condition, and 18 patients were associated with ascariasis, clonorchiasis and common bile duct cancer. Clinical symptoms and laboratory findings were not significantly helpful in diagnosis. The most effective means of diagnosing hepatolithiasis preoperatively were endoscopic retrograde cholangiography, percutaneous trans-hepatic cholangiography, or both. Stones were found mainly in the the left hepatic duct. Treatment consisted of T-tube choledochostomy, transduodenal sphincteroplasty, choledochostomy, Roux-en-Y choledochostomy. Templton-Dodd procedure and left lateral segmentectomy of the liver with cholangiojejunostomy or T-tube choledochostomy. Better results were noted in Roux-en-Y cholangiojejunostomy rather than choledochoduodenostomy. Hepatic segmtectomy with a drainage procedure was thought to be the treatment of choice when there are multiple stenosis in the unilateral hepatic duct.