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韓國人膽石症患者의 總輸膽管切開의 適應症에 關하여 Indications for Common Bile Duct Exploration in Korean

대한외과학회지 1974년 16권 10호 p.33 ~ 36
민병철,
소속 상세정보
민병철 (  ) 
서울대학교 의과대학 외과학교실

Abstract


It is universally accepted that the incidence and variety of intracholedochal pathology among Korean population is far greater than that of American population. Most Korean literatures show the common duct exploratin rate to be aroung 80% (vs. 20~40% in U.S.) with positive finding discovery rate of 40~50% (vs. 30~60% in U.S.). Overall stone discovery rate from common bile duct of Korean patients ranges from 28 to 77% while the figure is between 7 to 16% among American population.
Question of exploring or not exploring a given common duct intraoperatively is the mast frequently encountered question any abdominal surgeon must face, and the present series of 538 cases of biliary tract diseases in Korea were analysed to see whether or not "the indication for common duct exploration” which is widely accepted in American literature is also applicable to Korean population.
Following the each items of indication, it was found that the size of the common duct and history of jaundice was a poor indicator of intracholedochal pathology. Small multiple stones with patent cystic duct also belonged to this category.
Over all, 67% of positive indication cases yielded positive results while 18% of negative indication group contained intracholedochal pathology of sigmiicance.
Only hope of aviding unnecessary common duct exploration seen to rest in the improvement in technic of intraperative cholangiography and the cooperation between the two departments.

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