A clinical study of the effect of aging on biliary tract diseases
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概要
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1. Abnormal cholecystogram was found in 21% of 866 cases examined for routine physical examination performed in Keio University Hospital. Silent stone of the gallbladder was found in 1.6% of the cases. The incidence of abnormalities increased gradually with age. In admitted patients biliary diseases increased related to ageing. Cancers of biliary tract appeared after fifty years old statistically and the high incidence (13.5-16.5%) of the cholelithiasis of respective age groups from fifty to seventy years old.<BR>2. The statistic correlation between diabetes mellitus and biliary diseases were observed from the study of 10, 178 admitted patient including 445 diabetes mellitus, but no correlation existed between serum cholesterol and obesity. The abnormalities of lipoprotein fraction with increased β-and decreased α-fractions and fatty change of the liver (50%) of biopsied cases also indicated metabolic disturbance in biliary diseases.<BR>3. The means of sizes of gallbladder in X-ray are slightly elevated in female over fourty yeares old, but not in male. Gallbladder bile collected from 36 autopsied male without biliary and hepatic diseases were examined. The content of total bilirubin, total bile acids and total cholesterol decreased in aged patients, but the ratio between cholesterol and bile acids revealed no tendency related to age. The results indicated hypofunction of concentration of the gallbladder in aged men.<BR>4. Histological change of fibrosis with elastosis in aging existed in biliary tract and the change was most marked in the gallbladder. Portal fibrosis and elastosis were more prominent with the age and especially marked in cases with dilated bile ducts. Elastic fibers were increased around the dilated bile ducts, in the wall of the portal vein branches, hepatic vein tributaries and tortuous hepatic arteries. A duplication of internal elastic lamina was noted in cases of the aged with markedly dilated biliary trees.<BR>5. The width of choledochus of intravenous cholecystogram showed dilatation in aged patients with biliary diseases, related to high incidence and degree of abnormal liver function test (Alkaline phosphatase, SGOT, SGPT elevation).<BR>6. The dilatation of the choledochus were ovserved in cases of one third of duodenal diverticuli and post-gastrectomy. Hypotonic duodenography performed on patients with choledochal dilatation showed abnormal pictures of Vater's ampulla in over 80% of fifty nine cases, such as parapapillary diverticulum, papillary deformity and swelling.<BR>8. As a conclusion the close relation between age and biliary tract diseases are observed from statistical, radiological, biochemical and histological aspects.
- 財団法人 日本消化器病学会の論文
財団法人 日本消化器病学会 | 論文
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