肝切除治疗肝内胆管结石

Hepatectomy for the treatment of hepatolithiasis

目的探讨肝切除治疗肝内胆管结石的疗效。方法回顾性分析了1991年1月至2004年6月255例肝胆管结石采用肝切除治疗的术式和治疗效果。结果肝切除术式:左外叶切除175例(68.62%),左半38例(14.90%),右肝叶或段切除35例(13.73%),其中右半肝切除5例,双侧多肝段切除22例(8.63%),同时作胆肠内引流73例(28.63%),手术并发症22(8.63%),无术后死亡。结石残留32例(12.55%),其中29例经胆道镜取干净。221例(86.67%)获随访1至13年平均7.5年,优良率达89.59%。结论肝切除是治疗肝内胆管结石安全、有效的方法,其中早期肝胆管结石的肝切除治疗效果最佳,术中B超及纤维胆道镜在处理肝内胆管结石中起重要作用。

Objective To investigate the therapeutic effect of hepatectomy for hepatollmlasls.Methods From January 1991 to June 2004,255 cases with hepatolithiasis received hepatectomy were analyzed restrospectively.Results 255 patients underwent opoeration.Among them, 175（168.63%）underwent left lateral lobectomy, 38 （ 14.09% ）left hemihepatectomy, 35 （13.73%）rightlobectomy or segmentectomy and 22（8.63%） multilobectomy. In addition, 73 of them （28.63%）alsoreceived choledocho-jejunostomy. Postoperative complications were occured in 22 patients （8.63%）and no one died after operation. 221（86.67%）patients were followed up from 1 to 13 years （average7.5 years）. The excellent and good rate were 89.5%.Conclusion Hepatectomy is an effective and safe therapeutic method for hepatolithiasis and it＇s use of early stage can get a good results. Intraopertive. Ultrasound and fibro choledochcope are very important to manage the hepatolithia.