肝叶切除联合术中B超及胆道镜治疗肝胆管结石并狭窄43例临床分析

Clinical analysis of 43 cases of hepatobiliary calculus and stricture treated by hepatic segmental resection combined with surgical operation

目的总结肝叶切除联合术中B超及胆道镜治疗肝胆管结石并狭窄的疗效。方法1991年1月至2005年5月对肝胆管结石并狭窄43例患者采用肝左（外）叶切除36例（83．7％），右肝切除5例（11．6％），肝方叶切除2例（4．6％）。结果术后并发症4例（9．3％），包括膈下感染、胆道出血等。无手术死亡。术后随访41例。失访2例，4l例随访8个月～12年，37例无结石复发。优良率90．2％。结论肝叶切除联合手术是当前治疗肝胆管结石并狭窄的理想有效术式。

Objective To sum up the effect of the hepatic segmental resection combined with surgical operation for hepatobiliary calculus and stricture. Methods The clinical date were investigated in 43 cases of hepatobiliary calculus and stricture treated by hepatic segmental resection combined with surgical operation from Jan. 1991 to May. 2005. Results Left lateral lobectomy was performed in 36 cases （83.7 % ）, quadrate lobectomy 2 case （4.6 % ） and right lateral lobectomy 5 cases （ 11.6 % ）. Postoperative complication rate was 10.9% and the complications included biliary fistula and subcliaphragmatic infection. No death occurred in this series. Forty - one cases were followed up after operation form 8 months to 12 years. No stone re - occurred and good result was achieved in 90.24 % of all patients. Conclusion Hepatic segmental resection combined with surgical operation is an ideal and effective treatment for patients with hepatobiliary calculus and stricture