肝硬化门脉高压症脾切除一期行胆囊切除术17例治疗经验

Homochronous operation of lien and gallbladder for cirrhotic potal hypertension concurrent cholecystolithiasis:areport of 17 cases.

目的总结肝硬化门静脉高压症合并胆囊结石的临床治疗经验。方法回顾性分析17例肝硬化门脉高压症合并胆囊结石并行手术治疗患者的临床资料。结果本组在行脾切除、贲门周围血管离断术的同时行胆囊切除6例,其中3例术后出现大出血,2例死亡;行胆囊大部切除10例,行胆囊取石加造瘘1例,均无并发症发生,痊愈出院。结论肝硬化门脉高压症脾切除一期行胆囊切除术具有可行性,主要危险在于术中难以控制的大出血和术后肝功能衰竭,胆囊大部切除术既可缓解症状,又可有效减少手术风险,可作为此类患者的首选。

Objective To evaluate the experience of treatment for cirrhotic potal hypertension concurrent cholecystolithiasis. Methods The clinical data of 17 patients with cirrhotic potal hypertension concurrent eholecystolithiasis undergoing splenectomy and eholecy.stectomy were retrospectively analyzed. Result Six patients underwented splenectomy, peri-cardiac devascularization and cholecystectomy simultaneously. Two patients died and three patients were hemorrhage, ten patients underwented partial cholecystectomy and one patients underwented cholecystostomy, all patients had no complications. Conclusion Cholecystectomy and spleneetomy can be carried out in selected patients with liver cirrhosis and portal hypertension. Uncontrollable hemorrhage and liver function failure are main risk. Partial cholecystectomy can relieve symptoms and reduce the risk of operation , therefore, as a preferred operation.