右肝内胆管孤立结石的病理特点与手术治疗

Patho-characteristic and operative treatment of isolated calculi in right intrahepatic bile duct

目的探讨右侧肝内胆管结石独特的临床病理特点及施行右侧肝叶切除的可行性和安全性。方法回顾性分析83例右侧肝叶切除和115例非肝叶切除的手术时间、出血量、住院时间、结石清除率和并发症。结果右侧肝叶切除的结石清除率高于未行肝叶切除的清除率,并发症发生率(45.8%)高于非肝切的并发症发生率(20.9%)。两组均无手术死亡。结论右侧肝叶切除是一种安全、高效的治疗右侧肝内胆管结石的方法,值得推广应用。

Objective To explore the feasibility and safety for right hepatolobectomy accordinging to the unique clinicopathologic characteristic in right calculus of intrahepatic duct.Methods Retrospective analysis the operation time,bleeding amount,lengths of patient stay（LOS）,calculus clearance rates and complications of 83 cases of right hepatolobectomy and 115 cases of non-hepatolobectomy.Results According to the unique clinicopathologic features of right calculus of intrahepatic duct,right hepatolobectomy could significantly increase clearance rate of gall-calculi and reduce LOS compared to non-hepatolobectomy.Subtotal hepatectomy did not increase surgery operation time,LOS and complications compared to partial hepatectomy.Conclusion According to the unique clinicopathologic features of right calculus of intrahepatic duct,right hepatolobectomy is a safe operation with high-performance,it is worth promoting.