肝内外胆管结石合并CTPV外科治疗策略

The surgical strategies of cholangiolithiasis combined with cavernous transformation of portal vein

目的研究肝内外胆管结石合并CTPV的外科治疗策略。方法收集我院自2010年1月至2014年3月共收治肝内外胆管结石患者670名,其中肝内外胆管结石患者合并门脉海绵样变性患者9例。分别采用ERCP/EST取石,胆总管切开取石,肝叶部分切除和分期手术方法。结果手术残石率44.4%(4/9),治疗总残石率22.2%(2/9)。ERCP取石成功2例,胆总管探查取石+T管外引流3例,肝叶部分切除3例,分期手术1例,术中输血率33.3%(3/9)。结论完善的术前影像学诊断,个体化的外科治疗方案,精准的外科操作,是诊治此类患者的要点。

Objective To explore the surgical strategies of cholangiolithiasis combined with cavernous transformation of portal vein. Methods 9 cases cholangiolithiasis combined with CTPV from 670 cases, which were hospitalized from January 2010 to March 2014. Treatments included ERCP/EST, choledocholithotomy, liver lobectomy, and staging surgery. Results the rate of residual stones of postoperation is and the the overall rate of residual stones post-treatment is. 2cases were treated with ERCP/EST. 3 cases with choledocholithotomy and drainage of T tube, 3 cases with partial liver lobectomy, and 1 case with staging surgery. Conclusion The strategies for cholangiolithiasis combined with CTPV is individual, according to the complete imaging system, and elaborated surgical procedure.