多肝段切除治疗复杂肝内胆管结石临床分析

Clinical analysis of multiple segmental resection in the treatment of complicated hepatolithiasis

目的分析探讨多肝段切除治疗复杂肝内胆管结石的临床疗效。方法分析我院收治的107例肝内胆管结石患者的临床资料,其中54例(肝切除组)患者行多肝段切除+胆总管探查+T管引流的手术方式,其余53例(未切肝组)未行肝切除。术后平均随访6个月,观察比较两组患者临床疗效及并发症情况。结果肝切除组患者优良率83.3%,高于未切肝组的49.1%(P<0.01);肝切除组残石率低于未切肝组(P<0.01);两组肝功能及术后并发症发生率比较,差异均无统计学意义(P>0.05)。结论多肝段切除治疗复杂肝内胆管结石的疗效确切,且不影响肝功能,值得临床推广应用。

Objective To explore the curative effects of multiple segmental resection in the treatment of complicated hepatoli- thiasis. Methods A retrospective analysis of 107 patients with hepatolithiasis was made, in which 54 patients were treated with multi- ple segmental resection and common bile duct and hepatic duct exploration ＋ T pipe operation mode, the other 53 patients were not treated with liver resection. The postoperative follow-up lasted for 6 months. The clinical curative effects and complications of the pa- tients in both groups were observed and compared. Results The fineness rate of the patients in multiple segmental resection group （83.3%）was much higher than that of the patients without hepatectomy （49.1%） （ P 〈0. OI ）. The residual stone rate of the pa- tients in multiple segmental resection group was lower than that of the patients without hepatectomy（ P 〈 0. 01 ）. Liver function and postoperative complications of the patients in both groups have no statistical difference （ P 〉 0.05 ）. Conclusion Multiple segmental resection in the treatment of complicated hepatolithiasis which has good curative effects and has no influence on liver function is worthy of clinical application.