PRYMARY CHOLESTEROL HEPATOLITHIASIS

An analysis of stones occurring in hepatolithiasis was made using infrared spectrophotometry. Cases of cholesterol stones containing 70% or more cholesterol were found in 11 out of 49 cases of hepatolithiasis. Four cases were considered to be “primary cholesterol hepatolithiasis” judging from the location of stones, the presence or absence of gallbladder stone and cholecystitis and the presence or absence of dilation of the cystic duct. One out of the four cases was a 44-year-old female whose hepatic duct joining mode was normal and in whom stones were found in the localized dilated bile duct of the lateral descending branch. The other three cases consisted of 2 men and 1 woman, whose ages averaged 33 years. In these 3 cases, the joining mode of the hepatic ducts proved to be Type IV according to Ohoto's classificaiton and stones were found in the dilated bile duct distal to the junction. From studies of the cases already reported, the former was judged to be a typical case of “prymary cholesterol hepatolithiasis”.