肝硬化对胆道结石手术的影响与治疗体会

INFLUENCE AND TREATMENT OF CIRRHOSIS ON CHOLELITHIASIS SURGERY

目的 探讨肝硬化对胆道结石手术的影响。方法 通过设立严格的病例对照 ,比较了 49例肝硬化和非肝硬化患者胆道结石手术中出血情况及术后并发症发生率与病死率。结果 肝硬化组术中平均出血量 6 45± 80 3ml,对照组平均 77± 5 3ml(P<0 .0 1) ;肝硬化组术后并发症发生率和病死率分别为 5 3.1%和 12 .2 % ,而对照组分别为 18.4%和 0 ,两组比较有明显差异 (P值分别 <0 .0 0 1和 <0 .0 5 )。结论 肝硬化是导致胆道结石术中大出血、术后高并发症发生率和病死率的主要原因。

Objective To evaluate the influence of cirrhosis on cholelithiasis operations.Methods A case control study of 49 patients with or without cirrhosis who underwent operation for biliary calculus was undertaken.Their intraoperative hemorrhage,postoperative morbility and mortality were compared.Results The mean intraoperative hemorrhage was 645 ml(400ml～6000ml)in cirrhosis group,and 77ml (50ml～800ml) in non-cirrhosis group(P<0.01).The morbidity and mortality of biliary surgery in cirrhosis patients were 53.1% and 12.2% respectively,in contrast to 18.4% and 0 in non-cirrhosis patients(P<0.001 and P<0.05).Conclusions Liver cirrhosis was the main reason of excessive intraoperative hemorrhage,high postoerative morbidity and mortality.