肝切除术为主的联合手术治疗肝内胆管结石

HEPATIC LOBECTOMY AND SEGMENTCTOMY FOR HEPATOLITHIASIS

目的探讨肝切除术为主的联合手术治疗肝内胆管结石的方法及疗效。方法回顾分析2000年7月至2005年7月采用以肝切除为主的联合手术治疗肝内胆管结石169例的治疗效果。结果本组无手术死亡;有结石残留23例,残石率13.61%;随访145例,术后有轻度胆管炎症状者13例,占8.97%;再手术3例,手术优良率92.4%。术后并发症:本组36例发生手术并发症,发生率21.43%,包括胆瘘、肝断面感染、切口感染、胆道术后出血。结论以肝切除术为主的联合手术是治疗肝内胆管结石的有效办法,可降低残石率和复发率,提高手术疗效,肝叶、段切除是肝内胆管结石手术治疗的核心。

Objective To analyse curative methods and effects of hepatic lobectomy and segmentctomy for hepatolithiasis. Methods Clinical outcome of 169 case of hepatolithiasis were analysed from july 2000 to july 2005. Results The operation mortality was 0%. The residual stone rate was 13.61% （23/169）. 145 case were foUowup with. 3 cases reoperation, and 13 case of postoperative cholangitis. Not serious cholangitis of postoperation 8. 97% （ 13/145 ）. Operative excellent and good result rate was 92. 4% （ 134/ 145 ）. Postoperative complication rate 21.3% （36/169）. including bile linkage, hemibilia, infection of hepatic resction surface. Conclusion hepatic lobectomy and segmentctomy are effective methods for hepatolithiasis with lower rate of residual stone and recurrence and better clinical outcome.