胆道结石再手术100例临床分析

Clinical analysis of cholelithiasis reoperations for 100 patients

目的探讨100例胆道结石再手术患者再手术的原因、手术方法及预防措施。方法回顾性分析100例胆道结石再手术患者的临床资料。结果肝内胆管结石残留或再生73例;胆总管结石11例;胆肠吻合口狭窄7例;胆总管囊肿6例以及胆道恶性肿瘤3例。再次手术的方式主要为肝叶或肝段切除、胆总管T管引流、胆肠吻合等。结论术前正确的分析病情与充分的准备、术时选择恰当的手术时机与正确的手术方法以及术后综合的治疗,是预防再手术发生的关键。

Objective To investigate the causes, operation methods and prevention measures of cholelithiasis reoperation for 100 patients. Methods The clinical data of 100 patients who had received cholelithiasis reoperation were analyzed retrospectively. Results There were 73 cases of residual or regenerated stones in bile ducts of liver, 11 cases of common bile duct stones, 7 cases of anastomotic stenosis, 6 cases of choledochal cyst, and 3 cases of biliary malignant tumor. The operation methods of reoperation were mainly excision of liver lobe or hepatic segments, common bile duct T-tube drainage, and Roux-en-y anastomosis. Conclusion The key prevention measures for reoperation are accurate preoperative assessment and sufficient preparation, appropriate intraoperative occasion and methods, and postoperative treatments.