摘要
目的 探讨肝硬化门脉高压症伴胆囊结石患者一期手术治疗的可行性。方法 对11例肝硬化门脉高压症伴胆囊结石的患者作了脾切除加断流手术,并一期完成胆囊结石的处理(胆囊切除9例,胆囊次全切除2例)。结果 均顺利地度过麻醉及手术期,术后低蛋白血症及腹水5例,轻度肝性脑病、脾窝积液、应激性溃疡各1例,均应相应治疗后康复出院,平均术后住院时间为14天。结论 术前正确评价肝功能、手术中精细操作及加强围手术期的观察是减少术后并发症和死亡率的关键。
Objective To study the feasibility of portal hypertension with gallstones in cirrhotic patients by one-stage operation. Methods 11 patients with portal hypertension with gallstones were treated by splenecto-my plus pericardial devascularization and cholecystectomy performed in one-stage procedure. Results All cases were passing through the process of anesthesia and surgical operation well. Postoperative complications occurred in 5 cases of hypoalbuminemia with ascites, 1 slight hepatic encephalopathy, 1 subdiaphragmatic effusion and 1 stress ulcer. All of these patients recovered after appropriate treatment given. The average postoperative hospital stay was 14 days. Conclusions Adequate preoperative evaluation of liver function, accurate surgical manipulation and intensive perioperative observation are essential for reducing both postoperative complication and mortality rate.
