肝叶切除术治疗肝内胆管结石51例分析

The Analysis of treating hepatolithiasis with lobectomy in 51 cases

目的探讨肝叶切除术为主的外科综合方法治疗肝内胆管结石的效果。方法针对肝内胆管结石部位及肝门胆管狭窄情况，采用肝叶段切除，肝门胆管成形，引流，经肝断面胆道镜取石联合手术。结果本组51例无术中术后死亡，切口感染5例，术后腹水6例，残石4例，上消化道出血3例，随访11个月-9年，其中症状消失48例，胆管炎发作3例。结论以肝叶段切除术为主体，并结合个体化方案是目前治疗肝内胆管结石的可行、有效的方法之一。

Objective To discuss the effects of surgical combined therapy for hepatolithiasis which using liver lobectomy as a main method. Methods According to the stones＇situations in bile duct and the narrow degree of bile duct in hepatic hilum, in hepatolithiasis and intrahepati duct, the methods of liver lobectomy, hepatic portal canal forming, drainage and combined operatin of stone removal with hepatic biliary tract mirror via kiver cross section.are adopted. Results All 51 cases received operation. No death took place at the intraoperative and postoperative period. There were 5 cases of incision infection, 6 cases of abdominal dropsy, and 4 cases with residual stones after operation. There were 3 cases of hemorrhage of upper gastrointestinal tract. Followup ranged from 11 months to 9 years,there were 48 cases of symptoms disappearing,3 cases of cholangitis episode. Conclusion Combine liver lobectomy with individualization should be a feasible and effective treatment option for hepatolithiasis.