肝内胆管结石外科手术治疗155例分析

Surgery treatment for hepatolithiasis:An analysis of 155 cases

目的 :探讨肝内胆管结石外科手术治疗的有效措施。方法 :15 5例分别行胆总管切开取石或纤维胆管镜术中、术后取石及肝切除加各种胆肠吻合术。结果 :死亡 5例 ,残余结石 2例 ;并发胆管癌 2例 ,肝脓肿 4例 ,支气管胸膜瘘 2例 ,均经治疗后痊愈 ,总治愈率达 96 .87%。结论 :单纯胆总管切开取石效果较差 ,附加纤维胆管镜术中、术后取石效果满意 ,肝切除疗效最佳 ;但全肝多发性结石附加各种引流术 。

Objective:To investigate the effect of surgical treatment on hepatolithiasis.Methods:One hundred and fifty five cases were treated by choledocholithotomy,choledochoscopy removing stones in or post operation and hepatectomy plus a series of drainages.Results:Five patients died,2 had residual stones,2 were complicated by bile duct carcinoma,4 had hepatic abscess and 2 broncho pleural/fistula.The overall cure rate was 96.87%.Conclusions:The effect was poor by chloledochocholithotomy alone.Plus fiberscope removing stones in or post operation was more satisfactory.The most effective therapy was hepatectomy,but for the multiple stones of whole liver,a series of drainages should be applied to guarantee the success of operation.