左肝外叶切除术联合胆道镜治疗左肝内胆管结石的临床研究

The Study on Left Lateral Lobectomy Combined with Fiber Choledochoscope for Left Hepatolithiasis

目的探讨左肝外叶切除联合术中胆道镜治疗左肝内胆管结石的效果。方法对我院2007年1月至2012年12月收治的46例左肝内胆管结石病人同期分别采用两种手术方法治疗。A组25例采用肝左外叶切除联合术中胆道镜取石术;B组21例采用左半肝叶切除术,对两组的术中情况、术后并发症和近期疗效进行分析比较。结果 A组与B组患者的术前一般资料之间差异无统计学意义(P>0.05);A组术中出血量、手术时间和术后并发症的发生率显著低于B组(P<0.05);A组和B组的术后优良率和结石残余率的差异无统计学意义(P>0.05)。结论肝左外叶切除联合术中胆道镜治疗左肝内胆管结石是安全、有效手术方式。

Objective To study the effect of left lateral lobectomy combined with fiber choledochoscope for left hepatolithiasis. Methods 46 cases of left hepatolithiasis underwent surgical treatment from ]an 2007 to Dec 2012 in our hospital were analyzed. 25 patients underwent left lateral lobectomy combined with fiber choledochoscope to remove calculus （Group A） ; 21 patients underwent left hepatectomy to remove calculus （Group B）. The operation efficiency, postoperative complications and immediate outcomes were compared between the two groups. Results No marked difference was found between group A and B about basic data （P 〉 0.05 ）. But there were significant difference in operation time, Intraoperative bleeding and postoperative complications between group A and B （ P 〈 0.05）. The postoperative stone residual rate and effective rates of the two groups were no statistical significance（P 〉0. 05）. Conclusions Left lateral lobectomy combined with fiber choledochoscope for left hepatolithiasis is the safe and effective.