Kondo S, Nimura Y, Hayakawa N, Kamiya J, Okamoto K, Maeda S, Shionoya S
Nihon Shokakibyo Gakkai Zasshi. 1989 Dec;86(12):2779-86.
Cholangiographic investigations in 16 patients with primary intrahepatic cholesterol stones yielded some characteristic findings as follows. 1. Several numbers of stones were filled within locally dilated portion of the subsegmental or more peripheral intrahepatic bile duct branches, with no or minimal dilatation of the more peripheral portion and no stenosis-like lesions of the more hilar portion. 2. The lesion was single or multiple scattered in the liver and intrahepatic cholangiogram excluding involved segments was almost normal. 3. Although extrahepatic bile duct and/or gallbladder stones were often associated, the normal gallbladder, cystic duct and papillary portion and slightly dilated common bile duct were demonstrated. These cholangiographic findings were compatible with the endoscopic findings that inflammatory changes of the bile duct were rarely observed. According to above mentioned findings, it is suggested that the etiology of this disease differs from intrahepatic stones of calcium bilirubinate and dissolution therapy with bile acid may be available.
对16例原发性肝内胆固醇结石患者进行的胆管造影检查得出了一些特征性结果,如下所示。1. 亚段或更外周的肝内胆管分支的局部扩张部位内充满了多个结石,更外周部分无扩张或仅有轻微扩张,肝门部无类似狭窄病变。2. 病变在肝脏内为单个或多个散在分布,除受累节段外,肝内胆管造影基本正常。3. 尽管常伴有肝外胆管和/或胆囊结石,但胆囊、胆囊管和乳头部分正常,胆总管轻度扩张。这些胆管造影结果与内镜检查结果相符,即很少观察到胆管的炎症变化。根据上述发现,提示该病的病因与胆红素钙肝内结石不同,胆汁酸溶解疗法可能有效。