原发性肝癌术后并发胆囊炎、胆囊结石成因分析

Study on post-hepatectomy cholecystitis or cholecystolithiasis in primary hepatic carcinoma patients

目的 :探讨原发性肝癌术后并发胆囊炎、胆囊结石的成因。 方法 :对 40 0例原发性肝癌患者的临床资料及随访结果进行分析。结果 :术后并发胆囊炎、胆囊结石者 86例 (2 0 .75 % )。 40 0例中合并乙型肝炎 (乙肝 )及肝炎后肝硬化、伴有腹水及术中行肝门阻断的患者 ,术后胆囊炎、胆囊结石的发生率均较不伴乙肝及肝炎后肝硬化、无腹水及术中未行肝门阻断的患者明显增加 ;而术后胆囊炎、胆囊结石的发生率在有无输血以及肝门阻断时间长短之间无显著性差异。结论 :原发性肝癌患者术后并发胆囊炎、胆囊结石是多因素综合作用的结果 ,包括术前存在易患因素、机械因素、胆囊血液灌注不足等。其结果是导致胆囊收缩功能减弱、胆汁淤滞、胆汁成分改变而引起胆囊炎。

Objective:To study the factors in primary liver carcinoma complicated with cholecystitis or cholecystolithiasis after hepatectomy. Methods: Clinical and follow-up data were analyzed in 400 patients. Results: Cholecystitis or cholecystolithiasis were found in 86 cases after hepatectomy (20.75%).Incidence of cholecystitis or cholecystolithiasis in patients complicated with hepatitis B, posthepatic cirrhosis, ascites and porta hepatis occlusion was higher than that in non-hepatitis B,non-posthepatic cirrhosis and ascites patients. There was no obvious difference in incidence between with blood transfusion or without and the length of porta hepatic occlusion. Conclusion: It is concluded that multiple factors participates in this process,including proneness to the disease before operation, mechanic reason,insufficient blood supply of gall bladder, etc .Depressed function of cholecyst constriction,cholestasis and changes of bile components may lead to the inflammation of cholecyst and the formation of gallstone.