Long-term results of surgical treatment for intrahepatic stones

One hundred and nineteen patients with intrahepatic stones treated surgically in Nagasaki University Hospital from 1969 to 1984 were reviewed. The patients were divided into four types according to location of the stones and the presence or absence of stenotic lesions and/or localized dilatation of the intrahepatic bile ducts. Types I and II patients were treated with choledocholithotomy or choledochojejunostomy, while type III patients underwent hepatic resection and type IV patients were treated by partial hepatic resection with bilioenteric anastomosis, including extended hepatico-choledochojejunostomy. The majority of operative or early deaths belonged to type IV and residual stones were present in almost all patients. The long-term results for the 88 patients revealed that the rate of improvement was 100 per cent for type I, 87 per cent for type II, 83 per cent for type III and 84 per cent for type IV. In type IV, the most excellent results (92 per cent) were obtained by extended hepaticocholedochojejunostomy, especially with hepatectomy. It is suggested that extended hepaticocholedochojejunostomy with partial hepatic resection is a reasonable procedure for treating patients with type IV intrahepatic stones.     

Pericentral pigmentary retinal degeneration

We studied five patients with pericentral pigmentary retinal degeneration, whose fundus lesions were bilateral, symmetrical grayish zones with pigments surrounding the macular region. All showed good visual acuity, normal color vision, mild deterioration of scotopic electroretinographic response, normal photopic electroretinographic response, subnormal electrooculogram and paracentral ring scotoma. The fluorescein angiography demonstrated hyperfluorescent dots around the macula. Their family history was noncontributory. The retinal lesions showed only very slow progression.