A CLINICAL STUDY OF 9 CASES OF UNSUSPECTED COMMON BILE DUCT STONE

In a recent 7-year period, 9 cases of unsuspected common bile duct stone, which were diagnosed by intraoperative cholangiogram, were experienced. In this study, these 9 cases were compared with 24 cases of common bile duct stone which were diagnosed preoperatively, and 66 cases of gallbladder stone, which were operated on for these two years, to search for prevention stratedy of remnant stones after cholecystectomy. Most of the unsuspected common bile duct stones were small cholesterol stones, and their cholecystic ducts were dilated, so we supposed that these stones were gallbladder origin. Preoperative diagnosis in these 9 cases was possible to predict from a history of jaundice, increases in GOT, T. Bilirubin, ALP and serum amylase, and a dilation of common bile duct, as well as from visualized pictures of small stones in the gallbladder by preoperative ultrasonography, DIC and CT. It is important that when we encounter a case probably coming under this category, intraoperative cholangiography should be performed, at least; and if common bile duct stones are suspected, choledochetomy has to be carried out for preventing postcholecystectomy remnant stones.