对胆石病诊疗的几点意见及经验

Clinical opinions and experiences in diagnosis and treatment of cholelithiasis

目的总结胆石症的治疗经验。方法对该院2012年1月-2013年1月收治的3 257例胆石症患者进行回顾性总结分析并分享特殊病例诊治经验。结果全组无手术死亡病例，术后并发症包括切口脂肪液化、胆瘘等，均经保守治疗痊愈，无膈下脓肿、胆道出血等并发症。结论肝内胆管结石外科治疗方法多样，临床应遵循“个体化治疗“方案，选择适当的手术方法，尽可能做到“肝胆四保”，即“保肝、保胆囊、保胆管、保Oddis括约肌”。

[Objective] To summarize experience in diagnosis and treatment of cholelithiasis. [Methods]3 257 cases of cholelithiasis patients treated in our hospital from January 2012 to January 2013 wereretrospectively analyzed and shared diagnosis and treatment of special cases. [Results] There were nooperative deaths, and the postoperative complications including wound fat liquefaction, biliary fistula, are curedby conservative treatment, no subphrenic abscess, biliary tract bleeding and other complications. [Conclusion]Surgical treatment of intrahepatic bile duct stones varied, clinical should follow the personalized treatmentprogram, select the appropriate surgical approach, as possible hepatobiliary four preservation, or protectinghver, gallbladder, bile duct and Oddis sphincter.