肝尾状叶胆管结石的诊断和治疗

Diagnosis and treatment of bile duct stones of caudate lobe.

目的 探讨尾状叶胆管结石的诊断和治疗。方法 对 35例尾状叶胆管结石病人的诊治进行回顾性总结并随访 ,随访率为 75 %。结果 近、远期疗效较好 ,经术后胆道镜检查、取石后 ,仅 4例发作胆管炎 ,5例结石复发 ,复发率为 14 3%。结论 尾状叶胆管结石诊断较为困难 ,术中仔细探查及胆道造影十分重要 ;左右肝管切开 ,直视下取石及狭窄扩张是尾状叶胆管结石治疗的关键。

Objective To investigate the diagnosis and treatment of cholelithiasis of caudal lobe of the liver.Methods 35 cases suffering fromcholelithiasis of the caudal lobe were reviewed.The rate of follow-up is 75%.Results There were only 4 cases attack cholongitis,and stone recurred in 5 cases undergoing fibrocholedochoscope treatment.The recurrent rate is 14 3%.Conclusion It is difficult to diagnose that disease.Introoperative exploration and cholangiograph is very important for its diagnosis.The keys of treatment are to incise the left and right bile duct and remove stone under direct vision and dilate the bile duct stricture.