肝部分切除术联合手术配合内镜下治疗肝内胆管结石

Heapatic lobectomy and segmentomy for hepatolithiasis

目的探讨肝部分切除术为主的联合手术治疗肝内胆管结石的方法及疗效。方法回顾分析2000年1月～2007年3月51例肝内胆管结石采用肝切除为主的联合手术治疗肝内胆管结石的术式和治疗效果。结果围手术期死亡3例,1例术中出血,1例术后中毒性休克继发肝、肾功能衰竭,手术病死率5.88%。术后残余结石7例,经术后胆道镜治疗,均取净结石。1倒术后死于DIC。33例获随访1个月～7年,2例症状复发,仅于发作时在当地抗炎治疗。1例肝胆管癌者术后4个月死于全身衰竭。结论以肝部分切除术为主的联合手术是治疗肝内胆管结石的有效办法,可降低残石率和复发率,提高手术疗效,肝部分切除术是肝内胆管结石手术治疗的核心。

[Objective] To explore the curative methods and effects of hepatic lobectomy and segmentectomy for hepatolithiasis. [Methods] The efficiency and patterns of operation were retrospectively analysed on 51 cases of hepatolithiasis from January, 2000 to March, 2007. [Result] 2 cases died in perioprative period, 1 had hemorrhage during the operation, 1 had toxic shock with liver and kidney failure, 1 case died of DIC. The operative mortality occurred in 5.88% patients, 7 patiens had residual stones, which were e...