87例肝内胆管结石外科手术治疗体会

Experience of 87 Cases Surgical Operation Treatment of Intrahepatic Bile Duct Stone

目的:探讨外科手术治疗肝内胆管结石的经验。方法:回顾性分析肝内胆管结石外科手术治疗87例,其中行胆总管切开取石T管引流术62例,肝左外叶切除5例,行左、右肝管或肝门部胆切开整形、胆肠吻合20例,全部病例都进行术中取石,2例术后纤维胆道镜取石。结果:全组病例手术治愈出院,术后残石2例,切口感染5例,吻合口漏1例,术后随访1～4年以上35例,其中结石复发6例。结论: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 87 cases from 2004 to 2009.The choledochotomy and taking stone and T tube drmnage is performed in 62 cases,the liver leafoutside the the left side to excises in 5 cases,the bile duct ofleft and right livers or fiver ministry bile duct to incises and plastic or cholanggioenterostomy in 20 cases,whole eases are examinedor raked stone with choledchoerseopy in intraopration or postopration. Results： The entire group case were cured,the occurrence of the residual stone was 2 cases, the margin infection was taken place in 2 examples, 1 case taken place the heal＇s leaks,The follow-up for 1-4 years performed in 35 patients that the stone recurs in 6 cases. Conclusion.＂ According to patient＇s individual conditions,a proper surgical procedure and postoperative comprehensive therapy are important for good outcome.