Current status of benign biliary disorders in Japan and accuracy rates of preoperative diagnoses. Collective review of 14,654 patients.

Data on 14,654 patients preoperatively diagnosed for benign lesions who had undergone surgical treatment during a 2 year period (April 1979 to March 1981) were obtained from 145 institutions. A total of 18,891 biliary disorders were confirmed and classified into 18 groups: stones in the gallbladder, 12,272 patients (83.7 percent of all patients); stones in the extrahepatic bile duct, 3,605 patients (24.6 percent); stones in the intrahepatic bile duct, 570 patients (3.9 percent); acalculous cholecystitis, 463 patients (3.2 percent); idiopathic dilatation of bile ducts, 375 patients (2.6 percent); stenosing papillitis, 274 patients (1.9 percent); benign stricture of bile ducts, 133 patients (0.9 percent); and others. Malignant tumors were found in 243 patients, of whom 132 (54.3 percent) were not expected to have gallbladder cancer. Accuracy rates for preoperative diagnoses in the patients with gallstones of the intrahepatic or extrahepatic bile ducts or the gallbladder, idiopathic dilatation of the bile ducts, benign stricture of the bile ducts, or benign stenosis of the papilla of Vater were higher than 90 percent. However, the false-negative rates for these six disorders, except gallstones of the gallbladder, were higher than 16 percent. Therefore, despite advances in diagnostic procedures before surgery, intraoperative examinations remain indispensable for determining the most effective approach to surgical repair.