胆石症再次手术405例分析

Re-operation Analysis of 405 Cases withHepatolithiasis following Secondary Operation

目的 :探讨胆石症再次手术的原因及防治措施。方法 :对我科过去 5年收治的 4 0 5例胆石症再手术病例的临床资料进行回顾性分析。结果 :再次手术主要原因为结石残留或复发 ,术前漏诊以及残株胆囊、胆管狭窄等。再次手术方式以胆总管切开T管引流术、胆肠吻合术、残株胆囊切除术、肝左外叶切除术为主。结论 :胆石症患者术前检查应尽量完善 ,明确结石部位 ,不应忽视胆囊切除术 ,胆肠吻合应采取大口吻合、以防止吻合口狭窄发生。

XIONG Xian ze,CHENG Nan shen,PENG Qi fang,et al.(Dept.of Surgery,West China Hospital,Sichuan University,Chengdu 610041,China) Abstract:Objective:Try to find out the causes of secondary operation after initial operation for hepatolithiasis,and then,clarify some methods to decrease its rate of occurrence.Methods:Retr ospective analysis of 405 patients with hepatolithiasis who were re-operated between the year of 1996 and 2001.Results:The main causes of the secondary operations we re remained stone and stone,missed diagnosis,stump cholecyst,and stenosis of the bile duct,etc.The secondary operations include d bile duct incision and T-tube drainage, choledochojejunostomy,stump cholecystecto my,and left liver lobectomy.Conclusions:Patients must be examed carefully before operation.To prevent the occurrence of stenosis of the stoma following choledochojejunostomy,the stoma should be made big enough.