肝内胆管结石的外科治疗

目的总结外科手术治疗肝内胆管结石的临床经验。方法回顾性分析我院自2004年1月～2009年12月外科治疗312例肝内胆管结石患者的临床资料。结果全组均顺利完成手术,无手术患者死亡。术后残余结石51例,胆漏15例,肠漏2例,腹腔严重感染2例,切口感染37例。结论胆管狭窄是结石复发和外科手术治疗失败的主要原因;肝切除术为主的联合手术是治疗肝内胆管结石的有效方法,可降低残石率和复发率。

Objective To summarize the clinical experience of the surgical intervention on the disease of intrahepatic bile duct stone.Methods The clinical data of 312 patients with intrahepatic bile duct stone who were treated in our hospital from 2004to2009 were analyzed retrospectively.Results All of the patients have been through the surgery successfully without dead.But there were 51 patients with retained calculus,15with biliary leakage,2 with intestinal leakage,2 with severe celiac infection,and 37 with infection of incisional wound.Conclusion The primary cause of the calculus＇ recurrence and the failure of the surgical intervention should be the stenosis of bile duct.The efficient way to treat this disease is to adopt the combination-surgery mainly with hepatectomy,which could decade the residue stone rate and the recurrence rate.