胆石症

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2 brown pigment stone HMG-CoA reductase cholesterol alphahydroxylase, Caroli UDCA MDR UDCA UDCA Shoda J, He BF, Tanaka N, et al. Primary dual defect of cholesterol and bile acid metabolism in liver of patients with intrahepatic calculi. Gastroenterology ; 108 : - Shoda J, Oda K, Suzuki H, et al. Etiologic significance of defects in cholesterol, phospholipid, and bile acid metabolism in the liver of patients with intrahepatic calculi. Hepatology ; 33 : - Ros E, Navarro S, Bru C, et al. Ursodeoxycholic acid treatment of primary hepatolithiasis in Caroli s syndrome. Lancet ; 342 : - Rosmorduc O, Hermelin B, Poupon R. MDR gene defect in adults with symptomatic intrahepatic and gallbladder cholesterol cholelithiasis. Gastroenterology ; 120 : - 114

3 PTCS EHL. -,., 115

4 Child BC.,.. -.,, PTCS PTCS Huang MH, Chen CH, Yang JC, et al. Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis. Am J Gastroenterol ; 98 : - Lee SK, Seo DW, Myung SJ, et al. Percutaneous transhepatic cholangioscopic treatment for 116

5 hepatolithiasis : an evaluation of long-term results and risk factors for recurrence. Gastrointest Endosc ; 53 : - Chen SM, Cheng YF, Chen FC, et al. Ductal dilatation and stenting for residual hepatolithiasis : a promising treatment strategy. Gut ; 42 : - Yoshimoto H, Ikeda S, Tanaka M, et al. Choledochoscopic electrohydraulic lithotripsy and lithotomy for stones in the common bile duct, intrahepatic ducts, and gallbladder. Ann Surg ; 210 : - Mori T, Sugiyama M, Atomi Y. Gallstone disease : Management of intrahepatic stones. Baillieres Best Pract Res Clin Gastroenterol ; 20 : - 117

6 CT CEACA- 118

7 -, 119

8 ; 21 : - ; 95 : - Cheung MT, Kwok PC. Liver resection for intrahepatic stones. Arch Surg ; 140 : - Chen DW, Tung-Ping Poon R, Liu CL, et al. Immediate and long-term outcomes of hepatectomy for hepatolithiasis. Surgery ; 135 : - Vetrone G, Ercolani G, Grazi GL, et al. Surgical therapy for hepatolithiasis : a Western experience. J Am Coll Surg ; 202 : - ; 52 : - ; 60 : - Jeng KS, Ohta I, Yang FS. Reappraisal of the systematic management of complicated hepatolithiasis with bilateral intrahepatic biliary strictures. Arch Surg ; 131 : - ; 14 : - Uchiyama K, Onishi H, Tani M, et al. Indication and procedure for treatment of hepatolithiasis. Arch Surg ; 137 : - 120

9 Takada EST EST 121

10 PTCL, confluence stone ESTEMLPTCSPTCC- SLPTBDESWLEHL, Takada T, Uchiyama K, Yasuda H, et al. Indications for the choledochoscopic removal of intrahepatic stones based on the biliary anatomy. Am J Surg ; 171 : - Tanaka M, Ikeda S, Ogawa Y, et al. Divergent effects of endoscopic sphincterotomy on the long-term outcome of hepatolithiasis. Gastrointest Endosc ; 43 : - Prat F, Fritsch J, Choury AD, et al. Laser lithotripsy of difficult biliary stones. Gastrointest Endosc ; 40 : - Ikeda S, Tanaka M, Matsumoto S, et al. Endoscopic sphincterotomy : long-term results in patients with complete follow-up. Endoscopy ; 20 : - Fujita R, Yamamura M, Fujita Y. Combined endoscopic sphincterotomy and percutaneous transhepatic cholangioscopic lithotripsy. Gastrointest Endosc ; 34 : - Confluence stone Gastroenterol Endosc ; 43 : - 122

11 PTCS sump syndrome Rouxen Y Roux PTCS ESWL MDCT MRCP PTCS ESWL 123

12 ., PTCD Gazzaniga GM, Bondanza G, Filauro M, et al. Intrahepatic lithiasis above a bilio-digestive anastomosis. Hepatogastroenterology ; 40 : - Khan TF, Sherazi ZA, Muniandy S, et al. Recurrent pyogenic cholangitis : sump syndrome following choledochoduodenostomy. Trop Doct ; 27 : - ; 24 : - Chijiiwa K, Tanaka M. Late complications after excisional operation in patients with choledochal cyst. J Am Coll Surg ; 179 : - Saing H, Han H, Chan KL, et al. Early and late results of excision of choledochal cysts. J Pediatr Surg ; 32 : - ; 24 : - Shima H, Yamataka A, Yanai T, et al. Intracorporeal electrohydraulic lithotripsy for intrahepatic bile duct stone formation after choledochal cyst excision. Pediatr Surg Int ; 20 : - Ajiki T, Suzuki Y, Okazaki T, et al. A large stone detected in Roux-en-Y jejunal limb years after excision of congenital choledochal cyst. Surgery ; 139 : - 124

13 ; 33 : - Rieber A, Brambs HJ, Lauchart W. The radiological management of biliary complications following liver transplantation. Cardiovasc Intervent Radiol ; 19 : - 125

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