肝切除治疗急性梗阻性化脓性胆管炎并发肝脓肿12例报告

Hepatectomy for the treatment of AOSC complicated by liver abscess:report of 12 cases

目的总结手术治疗急性梗阻性化脓性胆管炎(AOSC)并发细菌性肝脓肿的经验。方法回顾性总结9年来采取病肝切除治疗 AOSC 并发细菌性肝脓肿12例。其中结石致胆管梗阻11例,肝管癌致胆管梗阻1例。行左半肝切除2例,肝左外叶切除10例,均附加胆管探查、引流术。结果全组12例全部治愈。除术后有"T"型管周围感染2例,左膈下感染1例外无合并症,无手术死亡。随访11例,除因癌转移死亡1例外,其余10例均健在。结论由于切除了病灶,清除了感染源和结石形成的场所,消除了病因,防止了复发,疗效确切,是治疗 AOSC 并发肝脓肿的有效措拖。

To evaluate the effectiveness of hepatectomy for the treatment in patients of acute obstructive suppu- rative cholangitis (AOSC) complicated with liver abscess.Method During a period of 9 years hepatectomy was per- formed on 12 patients with AOSC complicated bacterial liver abscess,among them the abscess was caused by stones in Ⅱ patients,and by cholangiocarcinoma in of our,including left hemihepatectemy in 2 cases,and left lateral lobectomy of liver in 10 cases,all added by choledochotomy and T tube drainage.Result All patients were cured.Morbidity in- cluded incision infection in 2 cases,and left subphrenic infection.Eleven patients were followed up and all were healthy except one died of tumor metastasis.Conclusion Rationale use of hepatectomy in patients of AOSC complicating liver abscess eradicates infections foci hence is an effective treatment for these patients.