肝胆管结石的手术治疗

SURGICAL TREATMENT FOR HEPATOLOTHIASIS

目的总结手术治疗肝胆管结石的临床经验,方法回顾性分析261例肝胆管结石病人的手术方式及其疗效。结果261例中141例行胆管切开取石为主的联合手术,120例行肝切除术为主的联合手术(45.9%),其中早期的肝切除33例。肝切除组与非肝切除之间术后残石率差异显著,有统计学意义(11.6%vs34%,P<0.05),其中早期肝切除术后残石率为0。187例获得随访(75.8%),手术至随访时间6个月至15年,疗效优良者比例肝切除组优于非肝切除组(89.1%vs70.1%),其中早期肝切除优良率为100%。结论肝切除,特别是早期的规则性肝切除,是肝胆管结石目前最有效的治疗手段。

Objective To summarize the surgical experiences on treatment for hepatolithiasis. Methods The data from 261 cases with hepatolothiasis were reviewed. Result In 120 cases hepatectomy was performed , in the others choledochotomy,stone removal and biliary drainage was performed. Follow-up results showed that ptients with hepatectomy gad significantly less incideee of residual stone（11.6% vs 34% ,P〈0.05）and had better therapeutic resuh （89.1% vs 70.1%, P 〈 0. 05）. Conclusion Partial hepatectomy, especially early use of it , is presently the most effective treatment for hepatolit hiasis.