title: Therapeutic strategy for intrahepatic lithiasis.
abstract: Among the various benign biliary tract diseases, intrahepatic lithiasis is the most refractory condition to treat surgically. Recently, endoscopic treatment (mainly cholangiofiberscopic lithotomy) has been more and more frequently employed. A nationwide survey by questionnaire was conducted in 1985 to clarify the exact status of the current therapies for intrahepatic lithiasis in Japan. A total of 143 institutions (33.4%) responded to our questionnaire, and 2614 cases over a 10-year-period were collected and analyzed. Operation alone was performed in 53.8%, operation plus endoscopic treatment in 38.6%, operation plus dissolution therapy in 5.5%, operation plus endoscopic treatment and dissolution therapy in 0.04% and endoscopic treatment alone in 2.1%. The most common treatment was surgery. This was employed in 97.9% of all the patients, but endoscopic treatment was added in 40.7% of the cases to extract stones mainly intra- and/or post-operatively. Dissolution therapy was carried out occasionally, but with poor results. Conducting both adequate surgical biliary drainage and cholangiofiberscopic lithotomy may result in a marked improvement in the treatment of this intractable disease.
authors.affiliation: Second Department of Surgery, Nagasaki University School of Medicine, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Tsuchiya
authors.forename: T
authors.initials: T
authors.lastname: Eto
authors.forename: T
authors.initials: T
authors.lastname: Tsunoda
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: N
authors.initials: N
authors.lastname: Harada
authors.forename: M
authors.initials: M
authors.lastname: Koga
authors.forename: J
authors.initials: J
authors.lastname: Furui
mesh_terms: D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007564:Japan; D015337:Multicenter Studies as Topic; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D011795:Surveys and Questionnaires