手术治疗肝内胆管结石的疗效分析

Effect of surgery in the treatment of hepatolithiasis

目的：探讨肝内胆管结石外科手术治疗方式的临床疗效。方法回顾性分析98例肝内胆管结石患者的临床资料。肝胆管切开取石术91例，肝叶切除术7例。结果术后残留结石25例，死亡2例，在随访中发现再生结石10例，肝脓疡2例，合并胆管癌4例。手术总有效率97．96％。结论正确选择肝胆结石手术方式是减少术后残留结石的关键，左肝外侧叶切除，胆管镜的应用示减少术后胆管残留结石的主要手段。

Objective To explore the efficacy of surgery in the treatment of hepatolithiasis .Methods The clinical data of 98 patients with hepatolithiasis treated with different surgical procedures were retrospectively anan -lyzed,there were 91 cases transhepatic cholangiolithotomy treatment and 7 cases hepatolobectomy .Results 25 cases were found residual stone after operation .Recurrence calculus（10 cases）,liver abscess（2 cases）,and complicated by bile duct carcinoma（4cases） were found in following -up.2 cases were dead.The total effective rate was 97.96%. Conclusion Correct operation methods of calculus of intrahepatic duct was the key of reduction residual stone after operation.Resection extra-lateral lobe and choledchoscope are main means of reduction residual stone after opera -tion.