多发性肝胆管结石及狭窄的外科治疗

Surgical treatment of hepatobiliary stones combined with bile duct stricture

目的 探讨肝段切除与胆管切开取石术治疗肝胆管结石的临床效果。方法 回顾性分析3 16例肝内胆管结石及狭窄的外科治疗情况。其中采用肝段切除为主治疗 172例 ,采用胆管切开为主14 4例。结果 肝段切除组其残石率、再手术率明显低于胆管切开组 (P <0 .0 5 ) ,其优良率肝段切除组明显高于胆管切开组 (P <0 .0 5 )。结论 重视术前诊断和准备 ,采取以肝段切除为主 ,合理选择胆肠吻合术是治疗肝胆管结石的最佳方式。

Objective To explore the effect of hepatectomy or cholangiolithotomy on patients with hepatocholangic stones. Methods The clinical data of surgical treatment of 316 patients with hepatocholangic stones combined with bile duct stricture was retrospectively analyzed. The patients were divided into two groups:172 patients chiefly underwent hepatectomy,and the other 144 patients chiefly underwent cholangiolithotomy. Results The ratio of residual stones and reoperation in the hepatectomy group was significantly lower than those in the cholangiolithotomy group (P<0.05), and excellent effect percentage in hepatectomy group was clearly higher than that in cholangiolithotomy group (P<0.05). Conclusions Diagnosis and preparation should be emphasized before operation.Application of hepatectomy and choice of hepaticojejunostomy are the most effective ways in treating hepatocholangic stones.