肝切除治疗肝内胆管结石

Hepatic resection for hepatolithiasis

目的 探讨肝切除术治疗肝胆管结石的效果。方法 分析 1989年 7月～ 1999年7月采用肝切除术治疗 184例肝内胆管结石患者的结石部位和分布情况、手术方式、手术后并发症、病理结果等情况。结果 肝内胆管结石以左肝为主 (16 5例 ) ,肝切除也以左肝叶段切除为多 (15 3例 ) ;32例出现手术后并发症 (17 39% ) ,无手术死亡。随访 3月～ 10年 ,效果优良者占 96 2 0 % ,包括 4例早期胆管癌。结论 肝切除手术是治疗肝内胆管结石的有效方法。

Objective To evaluate the therapeutic effect of hepatic resection for hepatolithiasis. Methods A study was made on stones distribution, operation patterns, postoperative complications and pathological diagnosis in 184 patients with hepatolithiasis who underwent hepatic resection from July 1989 to July 1999. Result Left hepatolithiasis was the most common form (165 cases); left lateral lobectomy and left hepatectomy were most commonly performed procedures (153 cases). Postoperative complications occurred in 32 patients (17.39%) and no operative mortality. Follow up period from three months to ten years (mean 5.7 years) demonstrated that 96.20% of patients with excellent or good result, including 4 cases of early stage of cholangiocarcinoma. Conclusions Hepatic resection is an effective procedure for hepatolithiasis.