不同术式治疗肝内胆管结石疗效比较

Curative effect comparison of hepatolithiasis by different operation method

目的通过对肝内胆管结石患者不同术式疗效的比较,以选择适合患者的手术方式。方法将需要行手术治疗的239例患者分为4组,分别采用不同的手术方式,观察术后的残石率及结石复发率情况。结果胆总管切开取石术的残石率及复发率均高于纤维胆道镜取石术(P<0.05);纤维胆道镜取石术与腹腔镜胆总管切开取石术的疗效相比较差异无统计学意义(P>0.05);肝部分切除手术的残石率及复发率最低,且其对单纯结石的患者疗效要优于复杂结石患者(P<0.05)。结论对于不同的肝内胆管结石患者所选的方式也不相同,推荐使用纤维胆道镜取石术、腹腔镜手术及肝切除术。

Objective To choose the appropriate operation method through comparing curative effect of the patients with hepatolithiasis by different operation. Methods 239 patients requiring surgical treatment were divided into four groups. Each group adopt different operation method. The stone residual rate and stone recurrence rate of four groups were observed. Results The stone residual rate and stone recurrence rate of common bile duct incision were higher than those of fibro- choledochoscopic removal of stone（P 〈 0.05）. There was no significant difference on curative effect between common bile duct incision and fibro-choledochoscopic removal of stone（P 〉 0.05）. The stone residual rate and stone recurrence rate of hepatolobectomy was lowest,and it＇s curative effect for the patients with simple calculous was superior to that for the patients with complicated calculi（P 〈 0.05）. Conclusion Different operation mode is adopt for different patients with hepatolithiasis. Fibro-choledochoscopic removal of stone,laparoscopic surgery and hepatectomy are first choice.