625例肝内胆管结石不同术式疗效分析

Analysis of 680 Cases of Intrahepatobiliary Tract Stones Dealt with Different Operation Methods

目的 探讨肝内胆管结石不同术式临床疗效.方法 回顾性总结2000～2010年期间采用胆总管切开取石术、胆肠吻合术、肝叶切除术及肝叶切除加胆肠吻合手术治疗的625例患者临床资料.结果 胆总管切开取石术、胆肠吻合术、肝叶切除术及肝叶切除加胆肠吻合组优良率分别为69.9%、83.1%、92.7%和91.3%,肝切除组优于非肝切除组,二者比较差异有统计学意义.结论 肝切除术是目前治疗肝内胆管结石最为理想的术式,临床工作中应根据结石分布类型和伴随的病理变化个体化地选择术式,以求达到最佳疗效.

Objective To explore the clinical curative effect of different operation of intrahepatohiliary tract stones. Methods The clinical data of 625 cases with hepatolithiasis underwent surgical treatment from 2000 to 2010 in our hospital were retrospectively analyzed. Results The excellent curative rate was 69.9%, 83.1%, 92.7% and 91.3% in the group of percutaneous lithotomy of common duct, cholangiojejunostomy, partial resection of liver and partial resection of liver with cholangiojejunostomy respectively. There was a significant difference between curative effects of nonhepatoectomy and that of hepatoectomy, and the outcomes of hepatoectomy were better than those of nonhepatoectomy. Conclusion Hepatoectomy is the most ideal operation methods for hepatolithiasis. The personalized operation methods should be performed according to the type of distribution of stones and pathological modification for the best curative effect.