复杂肝内胆管结石的外科治疗

Experience of surgical treatment for the complex hepatolithiasis

目的探讨复杂肝内胆管结石的治疗方法及效果。方法对昆明市第一人民医院5年来收治的86例复杂肝内胆管结石86例患者的临床资料进行回顾性分析。结果无围术期死亡病例。术后结石残留13例,残石率为15.2%,其他并发症8例,其中肝功能不全(血清胆红素及转氨酶升高)1例,胆漏1例,膈下脓肿1例,肺部感染2例,切口感染5例,均经保守治疗治愈。结论对治疗复杂肝内胆管结石,根据具体病情,术前制定个体化治疗方案,术中采取合理的手术方式,可提高结石治愈率,降低手术风险。

Objective To investigate the effect of treatment on complex hepatolithiasis. Methods The clinical data of 86 cases of complex hepatlithiasis were retrospectively analyzed. Results No perioperative death case was found. There were 13 cases ofpostoperative residual stones,the rate of residul stone was 15. 2% . Eight cases had other complications,including 1 case of liver dysfunction,1 case of bile leakage,1 case of subphrenic abscess,2 cases of pulmonary infection,5 cases of incision in-fection,all cases were cured by conservative treatment. Conclusion To treat complex Hepatolithiasis,we should develop indi-vidualized treatment programs preoperative according to the specific condition,and conduct different surgery intraoperative,which can improve the cure rate of stones and reduce the risk of surgery.