肝胆管结石合并无肝左、右管异常的外科治疗

Surgical treatment for bile duct stone with absence of hepatic duct abnormality.

目的 注意肝胆管结石合并胆管变异 ,提高肝内胆管结石的诊断治疗水平。方法 总结 2 0 0 12 0 0 2年来手术治疗的 5例肝胆管结石合并无肝右管或肝左管病例的诊断治疗过程和治疗方法。结果 5例病人都是手术中被发现肝胆管结石合并胆管变异 ,其中 4例为无肝右管 ,1例为无肝左管 ,均行不同部位的肝切除和胆管空肠吻合 ,术后无残石、治疗效果良好。结论 对肝胆管结石需警惕合并胆管异常 ,治疗应争取切除结石并胆管异常的肝叶。

Objective To evaluate the clinical significance of bile duct stone with bile duct abnormality and improve the surgical technique and diagnostic ability for this situation.Methods We retrospectively analyzed the diagnostic and treatment data of 5 cases of bile duct stone with absence of hepatic duct abnormality during the past one year.Results All 5 cases of abnormality were confirmed during surgical exploration. For these abnormalities, 4 cases were absent of right hepatic duct and 1 case was absent of left hepatic duct. Stone extraction with liver resection and hepatojejunostomy were carried out for this group of patients. The results were good and there were no reports of residual stones or surgical complications.Conclusion Bile duct abnormality should be noticed during surgery exploration for hepatic stones. Resection of lithogenic and anatomically abnormal liver lobe is required for a successful operation in this situation.