Kitagawa Yuichi, Nimura Yuji, Hayakawa Naokazu, Kamiya Junichi, Nagino Masato, Uesaka Katsuhiko, Oda Koji, Ohta Atsushi, Jan Yi-Yin, Cheng Long-Ping, Hwang Tsann-Long, Chen Miin-Fu
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
J Hepatobiliary Pancreat Surg. 2003;10(5):377-81. doi: 10.1007/s00534-002-0834-3.
BACKGROUND/PURPOSE: We analyzed confluence patterns of intrahepatic segmental bile ducts, seeking to relate hepato-lithiasis to anatomic variation. The comparative study was completed patients with hepatolithiasis in Taiwan and Japan.
Direct cholangiography was performed in 103 hepatolithiasis patients in Taiwan and 77 in Japan. Segmental ducts patterns were classified as type I, normal configuration; type II, "triad" confluence; type III, posterior segmental duct joining left hepatic duct; or type IV, distal confluence of the right posterior segmental duct.
Taiwanese patients had only calcium bilirubinate or black stones, and were mostly female. As overall analysis, types I, II, III, and IV were found in 61, 26, 13, and 3 patients, respectively. In Japanese, types I, II, III, and IV were found in 52, 10, 13, and 2, respectively. There was no difference between the two institutes. Since no patients in Taiwan had cholesterol calculi, Japanese patients were reanalyzed including only 58 patients with calcium bilirubinate or black stones. Differences in those populations remained insignificant.
Anatomic variations in segmental ducts apparently do not contribute to pathogenesis of hepatolithiasis.
背景/目的：我们分析了肝内段胆管的汇合模式，旨在探究肝内胆管结石与解剖变异之间的关系。对台湾和日本的肝内胆管结石患者进行了比较研究。
对台湾的103例和日本的77例肝内胆管结石患者进行了直接胆管造影。段胆管模式分为I型，正常形态；II型，“三联”汇合；III型，后段胆管汇入左肝管；或IV型，右后段胆管远端汇合。
台湾患者仅有胆红素钙结石或黑色结石，且大多为女性。总体分析显示，I型、II型、III型和IV型分别有61例、26例、13例和3例。在日本，I型、II型、III型和IV型分别有52例、10例、13例和2例。两所机构之间没有差异。由于台湾没有患者有胆固醇结石，因此对日本患者仅重新分析了58例有胆红素钙结石或黑色结石的患者。这些人群之间的差异仍然不显著。
段胆管的解剖变异显然对肝内胆管结石的发病机制没有影响。
