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정중기(Jung Kee Chung),서준석(Jun Suk Suh),홍인규(Inn Gyu Hong),권오중(Oh Joong Kwon),박연호(Yeon Ho Park),서경석(Kyung Suk Suh),김선희(Sun Whe Kim),박용현(Yong Hyun Park) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.1
N/A Background/Aims: Patient with choledocholithiasis(CL) may have residual stones postoperatively and cholodochoscopic extraction became one of the main therapeutic modalities recently. Analysing the incidence of postoperative residual stones in cholodocholithiasis patients and the effect of choledochoscopic stone remova], we may have the necessity of some modification of operation procedures such as cutaneous jejunostomy. Methods: Analysing c]inical data of 64 patients who were confirmed as having biliary stones during operation and were c>perated during the 4 year period until 1994, we investigated the relationship between operation modality and incidence of residual stone and effectiveness of endoscopic extraction and of medical management on postoperative periods. Results: Residua) stones(RS) were noted in 35.9%(23/64) of operated choledocholithiasis patients and by operative procedure, choledochojejunostomy cases had the highest incidence of RS at 58.3%. Complete removal of RS by choledochoscopy was achieved in 8 of 14 cases and two cases of recurrent and 4 case of remaining stones were managed medically. Conclusions: In managing CL patients, left lobectomy of liver is one of tbe definite treatment modalities in left sided CL and in right sided CL with high suspicion of RS, additive cutaneous jejunostomy on conventional choledochojejunostomy may have beneficial ro)e in long term postoperative choledochoscopic trial. (Korean J Gastroenterol 1997; 29:93 - 101)