肝内胆管结石128例诊治分析

Analysis on the diagonosis and treatment of 128 cases with intrahepatolithiasis

目的 探讨肝内胆管结石外科治疗方法的选择及疗效.方法 对2005年1月至2012年10月在我院接受手术治疗的128例肝内胆管结石患者的临床资料进行回顾性分析.结果 本组均行手术治疗,术后发生并发症15例（11.7％）,均经非手术治疗痊愈.术后结石残留24例（18.8％）,后经胆道镜T管成功取石9例.103例术后随访3个月～6年,疗效优良91例（88.3％）,再手术6例（5.8％）.结论 术前准确的病情评估,选用合理的手术方式,术中、术后配合胆道镜应用,是提高疗效、降低残石率、避免再手术的关键.

Objective To explore the effect and operative procedures of surgical treatment for intrahe- patolithiasis. Methods The clinical data of 128 cases with intrahepatolithiasis undergone surgical treatment from Jan. 2005 to Oct. 2012 in our hospital were analyzed retrospectively. Results All the patients underwent surgical treatment. The incidence of complications was 11.7%. The residual stone rate after operation was 18.8%. 103 patients were followed-up for 3 months to 6 years, The overall sufficient or complete remission rate was 91.1%, and 6 cases （5.8%） underwent reoperation. Conclusion Right evaluation and reasonable choice of surgical procedures, with intraoperative and postoperative cholangioscopy, are the key to achieving better treatment effect.