肝尾叶胆管结石46例诊治分析

THE DIAGNOSIS AND SURGICAL TREATMENT OF 46 CASES WITH CHOLELITHIASIS OF THE CAUDATE LOBE OF THE LIVER

目的 探论肝尾叶胆管结石的诊断与治疗。方法 回顾分析 1997年 8月～ 2 0 0 2年 3月我院收治的肝尾叶胆管结石 4 6例的诊断与外科治疗。结果 术前 B超无 1例发现肝尾叶结石 ,CT发现率为 10 /38(2 6 .3% )、ERCP发现率为 5 /8(6 4 .2 5 % )。肝尾叶结石同时合并肝内或胆总管结石 ,同时作肝段或肝叶切除 38例 ,作肝尾叶胆管成形术 9例 ,直接切开 4例 ,肝尾叶结石残留 2例。结论 重视本病及解除胆管狭窄、合并清除结石。

Objective To discuss the diagnosis and surgical treatment of the 46 cases with cholelithiasis of the caudate lobe of the liver.Methods From Aug.1997 to Mar.2002,46 cases suffering from cholelithiasis in the caudate lobe were treated in our hospital and analysed retrospectively. Results preoperative sonography,B type ultrasonography failed to find stones in this location.CT found 10/38 cases,ERCP found 5/8 cases,all the patients incorporated common bile cholelithiasis or hepatolithiasis,38 cases were performed segment or lobe hepatectomy,13 cases were treatd by bile duct cholangiotomy and 9 cases plasty in the caudate lobe.Among them 4 cases residual stones were found in the caudate lobe.Conclusion The most importance in diagnosis and treatment this diseases is that pay more attention on this disease,resolved stenotic bile ducts in the caudate lobe,removed the stones drastically and drainaged smoothly.