胆管结石再手术的临床分析

Clinical Analysis of Cholelithiasis Reoperation

目的探讨结石再手术的原因及手术方式。方法对93例胆道结石再手术病例再手术的原因和手术方式进行回顾性分析。结果结石复发是再手术的主要原因,经再手术93例中87例取净结石,结石取净率为93.5%,无重大并发症及死亡病例。结论再手术应遵循"清除结石,解除狭窄和梗阻,纠正畸形,切除病肝,通畅引流"的原则,根据不同情况选择合适术式,合理使用术中胆道镜可以减少术后结石残留。

Objective To investigate the causes and surgical procedures of cholelithiasis reoperation. Methods The causes and surgical procedures of 93 reoperative cases in our hospital between 2004 and 2009 were retrospectively analyzed. Results Recurrence of stone was the major reason of reoperation. 87 cases had the stones removed completely after reoperation without severe complication and death. The clearance rate of stones was 93.5%. Conclusion The rules of clearance of stones, removal of stricture and obstruction, plastic surgery of abnormality, removal of loci and smooth drainage should be followed. Appropriate surgical procedures should be used according to the patient conditions, and reasonably use of choledochofiberscope during operation can reduce postoperative residual stones.