肝切除术治疗左肝内胆管结石46例分析

The Treatment of Left Hepatolithiasis by Hepatectomy with a Report of 46 Cases

目的分析肝切除术治疗左肝内胆管结石的疗效。方法回顾性分析本院1999～2010年采用肝切除术治疗左肝内胆管结石46例患者的临床资料及随访情况。结果 44例为肝左外叶结石,实行左肝外侧叶切除+胆总管切开取石、T管引流术或胆总管空肠Roux-en-Y吻合术;2例为肝左内叶结石,实行左半肝切除+胆总管切开取石、T管引流术。无手术死亡病例,无结石残留病例,无再次手术病例,术后随访1～5年,复发率为2%。结论肝切除术治疗左肝内胆管结石安全性高、疗效理想,可作为左肝内胆管结石的首选治疗方式。

Objective To analyze the result of the the treatment of left hepatolithiasis by hepatectomy.Methods A retrospective record review of 46 cases（21 males,25 females） with left hepatolithiasis who received hepatectomy from 1999 to 2010.Results 44 cases who suffered from left extrahepatic bile duct calculus received left external lobectomy with choledocholithotomy or cholangioenterostomy（Roux-en-Y）.2 cases who suffered left hepatolithiasis received left hemihepatectomy with choledocholithotomy.All patients survived,there were no calculus residual cases,no reoperation case.The recurrence rate was 2% after 1-5 years follow-up.Conclusion Hepatectomy is the best choice for the treatment of Hepatolithiasis due to its high safety and ideal therapeutic effect.