复杂肝胆管结石再手术原因分析及防治

Complicated hepatolithiasis cause analysis and prevention of re operation

目的：对复杂肝胆管结石再手术的原因以及防治进行分析。方法：选择复杂肝胆管结石再手术患者97例为研究对象,对其一般资料、再次手术治疗方法等进行回顾性分析。结果：随访1～5年,随访83例,随访率为85.57%。因胆管癌、肝硬化以及门脉高压等死亡4例,死亡率为4.82%。随访对象均行纤维胆道镜检查,残石率为25.30%。术后随访无临床症状62例,经彩超及CT检查无结石再发81.93%,经彩超及CT检查结石再发12例,占14.46%。结论：结合复杂肝胆结石患者实际病情,把握治疗的时机选择最安全、有效的手术治疗方式,同时辅以中医治疗,能够提升复杂肝胆管结石的治疗疗效。

Objective To reason about complex intrahepatic biliary calculi before operation and control analysis.Methods Selection of complicated hepatolithiasis in 97 cases as the research object and operation,the general data,again operation treatment were analyzed retrospectively.Results Followed up for 1～5 years,83 cases were followed up,the follow-up rate was 85.57%.Because of bile duct carcinoma,liver cirrhosis and portal hypertension,4 cases died,the mortality rate was 4.82%.Follow up of patients underwent choledochofiberscope inspection,residual stone rate was 25.30%.Postoperative follow-up without clinical symptoms in 62 cases,the color Doppler ultrasound and CT examination no stone recurrence in 81.93%,by color Doppler ultrasound and CT examination in 12 cases accounted for 14.46% of the stone recurrence.Conclusion Combination of complex hepatolithiasis patients with actual condition,grasp the timing of treatment selection operation treatment is the most effective and safe,combined with traditional Chinese medicine treatment,treatment can improve the curative effect of complicated hepatolithiasis.