多处肝切除治疗复杂肝胆管结石病的并发症分析及防治

liver resection to treat complex if liver disease analysis and the prevention and treatment of complications

目的探讨复杂肝胆管结石病采用多处肝切除治疗的并发症及防治。方法本次共选择40例复杂肝胆管结石病采用多处肝切除治疗的患者,分析并发症类型及防治。结果本组选择病例清除率为95%。手术并发症率为67.5%,包括胸腔积液、术中大出血、膈下积液、切口感染、肝创面胆瘘、腹腔感染。因急性肝功能衰竭死亡1例。结论虽多处肝切除有较高并发症发生风险,且部分较严重,但熟练掌握肝切技术,严格把握手术指征,加强围手术期处理,选择适当肝切除方式,可有效降低并发症发生率,保障预后。

Objectives to study the hepatolith complicated disease by several liver resection treatment and prevention of complications. Methods the total choose 40 cases with hepatolith complicated disease patients treated using several liver resection, analysis type and the prevention and treatment of complications. Results select cases clearance rate was 95%. Operation complication rate was 67.5%, including pleural effusion, intraoperative bleeding, diaphragmatic fluid, incision infection, hepatic biliary fistula, abdominal cavity infection of the wound. Due to acute liver failure in 1 case death. Conclusions although several liver resection had a higher risk of complications, and part of the more severe, but mastering the liver cutting technology, strictly grasp the surgical indications, strengthen the perioperative management, selecting the appropriate way of liver resection, can effectively reduce the rate of complications and prognosis.