肝部分切除术联合胆道镜治疗肝内胆管结石临床研究

Clinical study on partial hepatectomy combined with choledochoscope in patients with calculus of intraheoatic duct

目的探讨肝部分切除术联合胆道镜治疗肝内胆管结石(CID)的临床疗效。方法选择2010年1月至2013年6月期间行手术治疗82例CID患者作为研究对象,随机分为两组,每组41例。观察组采用肝部分切除术联合胆道镜治疗,对照组采用胆管切开取石术联合胆道镜治疗,比较两组结石残留率和复发率、临床疗效及并发症发生率。结果观察组结石残留率、复发率均低于对照组,差异有统计学意义(P<0.05);观察组治疗优良率高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论肝部分切除联合胆道镜治疗肝内胆管结石疗效显著,结石残留率和复发率低,可作为肝内胆管结石优选的手术方案。

Objective To investigate the clinical effecacy of partial hepatectomy combined with choledochoscope for patients with calculus of intraheoatic duct（ CID）. Methods 82 patients with CID who received surgical treatment in department of hepatobiliary surgery from January 2010 to June 2013 were chosen as the objects of study. 82 patients were randomly divided into two groups,each group 41 cases. The observation group were treated with partial hepatectomy combined with choledochoscope. The control group were treated with choledochotomy combined with choledochoscope. The rate of residual stones,stone re-currence rate,clinical efficiency,incidence of complications of patients in two groups were compared. Results The rate of residual stones,stone re-currence rate of the observation group were lower than those of control group. The differ-ence was statistically significant（ P 〈0. 05）. The fineness rate of patients in the observation group was superior to that of controlled group. The difference had statistical significance（ P 〈0. 05）. compared the incidence of complications between two groups. There were no significant differ-ence（ P 〉0. 05）. Conclusion Partial hepatectomy combined with choledochoscope has significantly clinical effect,the rate of residual stone and recurrence rate are low. It can be used as the preferred operation plan in treatment of CID.