肝硬化门脉高压症脾切除联合胆囊切除术18例临床分析

Clinical Analysis of 18 Patients with Cirrhotic Potal Hypertension Concurrent Cholecystolithiasis Treated by Spleneetomy and Cholecysteetomy

目的:总结肝硬化门静脉高压症并胆囊结石的治疗经验。方法:回顾性分析1990年6月至2009年6月收治的肝硬化门脉高压症并胆囊结石行手术治疗18例的临床资料。结果:在行脾切除、贲门周围血管离断术同时行胆囊切除术12例、胆囊大部切除术6例,均痊愈出院。结论:肝硬化门脉高压症脾切除一期行胆囊切除术具有可行性,主要危险在于术中难以控制的大出血和术后肝功能衰竭;胆囊大部切除术既缓解症状,又减少手术风险,可作为此类患者的选择手术方式。

Objective：To summarize the experience of treatment for cirrhotic potal hypertension concurrent cholecystolithiasis.Methods ： The clinical data of 18 patients with cirrhotic potal hypertension concurrent cholecystolithiasis treated by spleneetomy and choleeysteetomy were analyzed retrospectively from Jun 1990 to Jun 2009.Result： 12 cases were underwent splenectomy, perieardiac devaseularization and cholecysteetomy simultaneously. 6 were underwent partial cholecystectomy. 18 cases were discharged improved.Conclusion：Cholecysteetomy and spleneetomy can be carried out in patients with liver cirhosis and portal hypertension.Uncontrollable hemorhage and liver function failure are main risks. Partial eholecystectomy can relieve symptoms and reduce the risk of operation, therefore, as a preferred operation.