肝胆管结石不同术式治疗体会

Different Surgical Treatment of Hepatolithiasis

目的:观察不同术式对肝胆管结石治疗疗效。方法:纳入2007年04月-2009年04月确诊为肝胆管结石患者103例为观察对象,根据患者病情分别采取不同术式。采用治愈性肝切除术29例;采用胆总管切开取石加胆肠内引流术38例;胆总管切开加胆道镜取石者36例。比较三种术式术后优良率、术后残石率和术后并发症发生率。结果:肝切除组和胆总管切开加胆道镜取石组患者优良率明显高于胆总管切开取石加内引流组(P<0.05)。肝切除组和胆总管切开加胆道镜取石组残石率明显低于胆总管切开取石加内引流组(P<0.05),三组并发症没有统计学意义(P>0.05)。结论:肝切除和胆总管切开加胆道镜取石治疗肝胆管结石疗效确切,残石率较低。

Objective:To observe the different surgical therapy for hepatolithiasis.Methods:The inclusion 2007-04/2009-04 diagnosed 103 cases of hepatolithiasis patients to observe the object,according to the patients were taken to different surgical conditions.Use of curative liver resection in 29 cases;used choledocholithotomy plus biliary drainage 38 cases;lithotomy common bile duct(LCBD) combined choledochoscope 36 cases.Comparison of three surgical methods for good after the rate of postoperative residual stone rate and the incidence of postoperative complications.Results:The liver resection group and the LCBD combined choledochoscope excellent rate of patients was significantly higher than choledocholithotomy plus internal drainage group(P <0.05).Liver resection group and LCBD combined choledochoscope group was significantly lower than the common bile duct stones plus internal drainage group(P<0.05),three groups of complications was not statistically significant(P >0.05).Conclusion:Liver resection and LCBD combined choledochoscope the exact efficacy of treatment of intrahepatic duct stones,residual stones was low.