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Ninety-two chronic biliary typhoid and paratyphoid carriers were operated on at Tokyo Metropolitan Toshima Hospital from January 1964 to December 1980. Out of these carriers, 90 had gallstones, and 2 were suspected of having gallstones. Carcinoma of the gallbladder was found in 5 carriers (5.4%). The carriers whose stool and bile cultures became negative by surgery alone were followed up for 4 months, while the carriers whose stool and bile cultures became negative by additional antibiotic treatment after surgery were followed up for 1 year. Out of 74 carriers who were followed up for the above perods, 70 (94.6%) were proved to be cured. The cure rate of 98.5% in 66 carriers with gallbladder stones was higher than that of 62.5% in 8 carriers with bile duct stones (p<0.005). Four failures had dilatation of the common bile duct. Furthermore, 1 of 4 failures had numerous intrahepatic duct stones.Since existence of gallstones is considered to be a major factor in the pathogenesis of the typhoid and paratyphoid carrier states, gallstones in these carriers must be completely removed by surgery. Chronic biliary carriers with gallstones should have a cholecytsectomy. A choledochotomy is indicated for the carriers with dilatation of the bile ducts or bile duct stones. We recommend to select a papilloplasty in the carriers who may have small bile duct stones. A long-term antibiotic treatment should be added in the carriers who have positive stool and bile cultures after surgery.
財団法人日本消化器病学会の論文

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