两种术式治疗区域型肝内胆管结石的临床疗效比较研究

Comparison of clinical effects of two surgical treatments for regional hepatolithiasis

目的比较胆总管切开取石与肝部分切除两种术式治疗区域型肝内胆管结石的临床疗效。方法选取医院收治的104例区域型肝内胆管结石患者,依据手术方式不同分为胆总管切开取石组(50例)和肝部分切除组(54例)。比较两组临床疗效、术后并发症发病情况、结石残余率、术后3年结石复发率。结果肝部分切除组总有效率为94.44%,显著高于胆总管切开取石组的82.00%(P<0.05);肝部分切除组并发症发生率为27.78%,显著高于胆总管切开取石组的12.00%(P<0.05);肝部分切除组残余结石率和3年内结石复发率分别为7.41%和5.56%,显著低于胆总管切开取石组的28.00%和22.00%(P<0.05)。结论对于区域型肝内胆管结石,肝部分切除术可减少术后结石残余率,虽并发症发生率较高,但临床疗效以及远期疗效较胆总管切开取石术均较优。

Objective To compare the clinical effects of two surgical treatments(laparoscopic common bile duct exploration and partial hepatectomy)for regional hepatolithiasis.MeAods A total of 104 patients with regional hepatolithiasis admitted into our hospital were selected as the subjects for the research and were divided into a LCBDE group(n=50)and a partial hepatectomy group(n=54).The clinical effect,incidence of postoperative complications,calculus residual rate and three-year calculus recurrence rate were compared between the two groups.Results The total effective rate of treatment of the partial hepatectomy group was 94.44%,significantly higher than that of the LCBDE group(82.00%)(P<0.05);the complication probability of the partial hepatectomy group was 27.78%,significantly higher than that of the LCBDE group(12.00%)^<0.05);the calculus residual rate and three-year calculus recurrence rate of the partial hepatectomy group were 7.41%and 5.56%respectively,significantly lower than those of the LCBDE group(28.00%and 22.00%)(P<0.05).Conclusion As for regional hepatolithiasis,partial hepatectomy can reduce the postoperative calculus residual rate.Despite a higher complication probability,the clinical effect and long-term effect are superior to the LCBDE procedure.