肝内胆管结石外科治疗598例分析

Surgical treatment for intrahepatic biliary calculi

目的探讨肝内胆管结石外科治疗的效果与方法。方法回顾性分析手术治疗 5 98例肝内胆管结石的临床资料。结果 87例 (14 .5 % )发生术后并发症 ,11例死亡。 5 16例 (86 .3% )随访 4～ 15年 ,疗效优良者 4 36例 (84 .4 % ) ,术后胆道残余结石 15 1例 (2 9.3% ) ,经再次手术与纤维胆道镜取石等方法 ,残余结石率降至 15 .3% (79例 )。随访期间 14例死亡。结论准确的定位诊断 ,适宜的手术方式和加强术后处理 ,可提高肝内胆管结石的治疗效果。

Objective To explore the effect of surgical treatment for intrahepatic biliary calculi. Methods Clinical data of 598 cases with intrahepatic biliary calculi treated by operation were analyzed retrospectively. Results Postoperative complications occurred in 87 cases (86.3%) and 11 died.516 cases (86.3%) were followed up for 4-15 years and the therapeutic effect was better in 436 cases (84.4%). As for 151 cases (29.3%) with residual stone in biliary tract, the rate of stone left was lowered to 15.3%(79 cases) which was removed by reoperation and through cholanioscopy. 14 died during follow-up. Conclusion The correct localization and diagnosis, appropriate operation and intensifying of postoperative management can improve the therapeutic effect for treating intrahepatic biliary stone.