CROSS SECTIONAL STRUCTURE, CHEMICAL COMPOSITION AND CHOLANGIOGRAPHIC FEATURES OF STONES OF THE GALLBLADDER:Studies of Indication for Dissolution Therapy

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Stones of the gallbladder from 174 patients obtained on surgery were divided into three principal groups of the radiated, lamellar and amorphous stones from gross findings of their cross section. A close relationship was found among their gross findings, chemical composition and cholangiographic features. Based on these results, the nature of gallstones is assessed with accuracy by the cholangiographic featue without inspecting the cross section or analysing the chemical composition.Various patient's position in cholangiographic procedure such as prone, supine or upright one were indispensable to demonstrate clearly the nature of the stone. Especially, compression upon the gallbladder area in upright position was essential for the study of fine calcification.Indication for dissolution therapy of gallstones was studied based on the cholangiographic features of 63 patients with cholesterol stones out of the 174 patients and of 29 patients in whom stones disappeared after chenodeoxycholic acid therapy. Floating stones and non-floating, round or oval, small or middle sized stones as well as similarly figured large stones in small numbers are indicated for the dissolution therapy.
財団法人日本消化器病学会の論文