胆肠吻合术联合肝叶切除治疗复杂肝胆管结石的临床效果

The Clinical Effect of Choledochojejunostomy Hepatectomy Combined With Treatment of Complex Bile Duct Stones

目的探讨复杂肝胆管结石胆肠吻合术联合肝叶切除治疗临床效果。方法选取复杂肝胆管结石80例,均为我院2013年9月-2015年9月收治,采用胆肠吻合术联合肝叶切除治疗,回顾临床预后。结果手术结束后,5例经T管造影有残留结石,其中经T管窦道用胆管镜取出3例,未取净2例,残石率为2.5%;胆瘘3例,隔下感染1例。结论针对临床收治的复杂肝胆管结石病例,采用胆肠吻合术与肝叶切除联合治疗,注意把握恰当的手术时机,在胆管炎症较重时先行胆管引流,将肝内外胆管结成解除,做好空肠吻合,可改善预后,保障手术质量。

Objective Discussion complicated bile duct stones choledochojejunostomy hepatectomy combined with clinical effect.Methods Select complicated bile duct stones,80 cases were hospital from September 2013 to September 2015 admitted to using choledochojejunostomy combined with hepatic resection,retrospective clinical prognosis.Results After surgery and 5 patients with T tube cholangiography residual stones,which through T tube sinus removed three cases with biliary mirror,did not take the net two cases,residual stone rate was 2.5%,three cases of biliary fistula,subphrenic infection in 1 case.Conclusion Hepatohthiasis for complex clinical cases treated using choledochojejunostomy hepatectomy with combination therapy,pay attention to the proper timing of surgery,biliary drainage in advance at the time of bile duct inflammation heavier,the extrahepatic bile duct form carefully lift and do jejunostomy,can significantly improve outcomes and ensure the quality of surgery.