胆道结石再手术24例临床分析

Clinical Analysis of Re-Operations in 24 Patients with Cholelithiasis

目的 :对胆道结石再手术发生的原因、治疗方式及疗效进行临床分析 ,以期避免或减少胆道残留结石的发生并提高疗效。方法 :总结 2 0 0 0年以来本院外科各类胆道结石病人治疗后的再次胆道手术病例 2 4例 ,从胆道结石手术后再次手术的原因、处理方法及治疗效果等方面进行分析。结果 :2 3例均无手术并发症 ,随访 5 a未再发作 ,1例因肝癌死亡。结论 :胆道再手术主要原因是胆管残余结石 ,并与结石的部位、胆道的病理改变、手术方式的选择、手术的合理操作、术者的经验、探查指征的掌握、病人的全身情况等多种因素有关。其中 ,多次胆道再手术的原因则以胆管和胆肠吻合口狭窄为主。胆道再手术以清除结石、纠正胆管狭窄和建立通畅引流为原则。

Objective To study features and causes of biliary duct re-operations and evaluate their therapeutic efficacy for avoiding its occurrence and decreasing its number.Methods 24 cases of the clinical data of all de patients receiving bile duct re-operations in our hospital from 2000 were retrospectively analyzed.Results 24 cases have no surgical operation complications, with visit 5 years and did not go into action again, 1 die because of liver cancer.Conclusion The main cause for re-operations is bile ston,and combine with various factor such as the reasonable operation of the choice, surgical operation of the pathologic change, the surgical operation method of part, fish for to point the whole body circumstance of the control, patient for advertise for etc. Stricture of bile duct and anastomosis is the most common cause for repeated re-operations. The purpose of re-operations is to clean up stones, correct strictures and build pathway for bile flow.