肝部分切除术治疗肝内胆管结石的疗效评价

Evaluation of the Efficacy of Partial Hepatectomy for the Treatment of Patients with Hepatolithiasis

【目的】探讨肝部分切除术治疗肝内胆管结石的疗效。【方法】回顾分析在本科接受肝部分切除术治疗的58例肝内胆管结石患者的临床资料。【结果】①所有患者均顺利完成手术，术后14例患者出现了并发症，其中肺部感染5例，应激性溃疡出血3例，胆漏3例，胆道出血2例，膈下脓肿1例，并发症发生率为24．1％。②8例患者有结石残留，结石残留率为13．8％。③经疗效判定，35侧优秀，16例良好，7例较差，无死亡病例，疗效优良率87．9％。【结论】尽管肝部分切除术治疗肝内胆管结石有一定的并发症与结石残留，但是该术式的疗效确切，可作为肝内胆管结石的常规方法之一。

[Objective] To explore the efficacy of partial hepatectomy for the treatment of hepatolithiasis. [Methodsl The clinical data of 58 patients with hepatolithiasis undergoing partial hepatectomy in our department were analyzed retrospectively. [Resultsl All patients were operated successfully. Postoperative complications occurred in 14 patients including 5 patients with pulmonary infection, 3 patients with stress ulcer bleeding, 2 patients with bile leakage, 2 patients with hemobilia and 1 case with subphrenic abscess. The incidence rate of postoperative complications was 24.1%. Eight patients had residual stones, and the residual stone rate was 13.8%. The therapeutic results showed that 35 patients were excellent, 16 patients were good and 7 patients were poor. No pa tient died. The excellent and good effective rate was 87.9%. [Conclusion]Partial hepatectomy for the treatment of hepatolithiasis has some postoperative complications and residual stones, but this surgery has certain efficacy and can be considered to be one of routine curative methods of hepatolithiasis.