解剖学肝切除在区域型肝内胆管结石中的近远期疗效观察

Short-and long-term effects of anatomic hepatectomy for regional intrahepatic cholelithiasis

目的探讨解剖学肝切除在区域型肝内胆管结石中的近远期疗效。方法选取2014年4月至2016年4月本院收治的76例区域型肝内胆管结石患者进行研究,按不同手术方法将其分为两组,各38例。对照组采取非解剖性肝切除术,观察组采取解剖性肝切除术。观察比较两组患者治疗后近期、远期临床疗效。结果观察组术中出血量、住院时间、胆漏、切面感染分别为(419.28±14.01)ml、(7.01±0.41)d、2.63%、7.89%,均低于对照组,差异均有统计学意义(均P<0.05);观察组结石复发率5.26%,低于对照组21.05%,差异有统计学意义(P<0.05)。结论解剖学肝切除应用于区域型肝内胆管结石中具有良好的临床疗效,可有效减少患者术中出血量、并发症发生率以及结石复发率,并缩短患者住院时间,值得临床推广应用。

Objective To investigate the short- and long-term effects of anatomical hepatectomy for regional intrahepatic cholelithiasis. Methods 76 patients with intrahepatic cholelithiasis treated at our hospital from April, 2014 to April, 2017 were randomly selected. According to different surgical methods, they were divided into a control group and an observation group, 38 cases for each group. The control group were treated with non-anatomical hepatectomy, and the observation group with anatomic hepatectomy. The short- and longterm clinical effects of the two groups after treatment were observed and compared. Results The intraoperative bleeding volume, hospital stay, bile leakage, and section infection were(419.28±14.01)ml,(7.01±0.41)d, 2.63%, and 7.89% in the observation group, which were significantly lower than those in the control group (all P < 0.05). The recurrence rate was lower in the observation group than in control group (5.26% vs. 21.05%, P < 0.05). Conclusion Anatomical hepatectomy has a good clinical effect on regional intrahepatic cholelithiasis, and can effectively reduce the intraoperative bleeding volume, the incidence of complications, and the recurrence rate, and can shorten the hospitalization time, so it is worth being clinically generalized.