经肝切开胆管取石术临床疗效分析

ANALYSIS OF 35 PATIENTS WITH INTRAHEPATIC BILE DUCT STONES TREATED BY TRANSHEPATIC CHOLANGIOLITHOTOMY

目的 评价经肝切开胆管取石术治疗肝内聚集性胆管结石的合理性和有效性。方法 35例肝内胆管结石病人在实施经肝切开胆管取石术后 1～ 5年复查 1～ 4次 ,每次复查均给予肝脏 B超等影像学检查 ,其中 8例还接受了再次手术治疗。结果 在术后 5年内 ,切开取石的胆管内结石复发 14例 ,复发率为 4 0 %。结石复发致肝叶段组织纤维化萎缩 12例 ,发生率为 34.3%。结石复发致再手术 8例 ,再手术率为 2 2 .9%。结论 经肝切开胆管取石术不是治疗内肝内聚集性胆管结石的适宜术式 。

Objective To estimate the rationality and validity of the transhepatic cholangiolithotomy in the treatment of intrahepatic bile collective stones.Methods 35 patients with intrahepatic bile stones had received transhepatic cholangiolithotomy were estimated by ultrasonography for 1～4 times in 1～5 years postoperatively.Results Stones recurred in local in 14 cases and recurrence rate was 40%.Liver lobe or segment fibroatrophy resulting from local stone recurrence occurred in 12 cases and occurrence rate was 34.8%.5 of them received operation again and the reoperation rate was 22.9%.Conclusion Transhepatic cholangiolithotomy was an unsuitable operative mode for treating intrahepatic bile collective stones.Mid-long-dated curative effect of the mode was poor.