摘要
目的探讨肝胆管残余或复发结石的再手术方式及其临床效果。方法回顾性分析107例肝胆管结石病人再次手术的临床资料,其中行胆总管探查+T管引流术58例,左肝外叶切除+胆总管探查T管引流术32例,肝左外叶切除+胆总管探查+(肝)胆管空肠Roux-en-Y吻合术8例,左半肝切除+胆总管探查T管引流术2例,胆总管探查+胆总管空肠Roux-en-Y吻合术2例,肝右叶部分切除+胆总管探查T管引流术3例,胆管空肠Roux-en-Y吻合口重建术2例。结果本组无死亡病例,术后发生胆漏4例,胆道出血1例,腹腔出血1例,切口感染3例,肺部感染3例,除1例腹腔出血行开腹止血外,余均经非手术治愈。86例获随访,平均10月(6月~3年),优良率占89.5%,9例(10.5%)结石再次复发,仍需进一步手术。结论肝胆管结石病人视病灶部位决定术式,以胆总管探查经胆道镜取石为主,联合肝叶切除,适当进行(肝)胆管空肠Roux-en-Y吻合术效果良好。
Objective To investigate the reoperation for the recurrent and residual hepatolithiasis.Methods 107 cases of reoperation for hepatolithiasis were retrospectively reviewed including common bile ductal exploration in 58 cases,common bile ductal exploration combined with partial hepatectomy in 45 cases,hepatojejunostomy in 12 cases.Choledochoscopy were performed routinely before the removal of T-tube.ResultsThere was no perioperative death.Complications observed in 4 cases of bile leakage,1 case of hemobilia,1...
出处
《中国现代手术学杂志》
2009年第1期29-30,共2页
Chinese Journal of Modern Operative Surgery
关键词
肝胆管结石
再手术
hepatolithiasis
reoperation
