肝内胆管结石外科手术治疗

目的探讨外科手术治疗肝内胆管结石的经验。方法回顾性分析我院自2000～2005年肝内胆管结石外科手术治疗63例，其中行胆总管切开取石T管引流术48例，肝左外叶切除10例，行左、右肝管或肝门部胆切开整形、胆肠吻合5例，全部病例都进行术中或术后纤维胆道镜检查或取石。结果全组病例手术治愈出院，术后残石4例，切口感染5例，吻合口漏1例，术后随访2～7年以上55例，其中结石复发8例。结论应要根据患者的情况，合理地选择手术方式，彻底清除肝内结石及相应病灶并结合术后综合治疗，是提高治愈率、减少术后并发症及残石率的关键。

Objective To study surgical operation treatment of intrahepatic bile duct stone.Methods Sums up the treatment experience of intrahepatic bile duct stone in 63 cases from 2000 to 2005. The choledochotomy and taking stone and T tube drainage is performed in 48 cases,the liver leaf outside the the left side to excises in 10 cases,the bile duct of left and right liv-ers or liver ministry bile duct to incises and plastic or cholanggioenterostomy in 5 cases,whole cases are examinedor taked stone with choledochofiberscopy in intraopration or postopration. Re-sults The entire group case were cured, the occurrence of the residual stone was 6.3% （4/63） the margin infection was taken place in 5 examples, 1 case taken place the heal＇s leaks,The follow-up for 2-7 years performed in 55 patients that the stone recurs in 8 cases. Conclusion According to patient＇s individual conditions, a proper surgical procedure and postoperative comprehensive therapy are important for good outcome.