胆道结石再手术52例临床分析

Clinical Analysis of Re-Operations in 52 Patients with Cholelithiasis Abstract

目的探讨胆道结石取石术后再手术的原因 方法总结了无锡市第一人民医院肝胆外科自1997年1月至2001年10月收治的52例胆道结石术后症状复发再手术患者的既往手术史及随访情况 结果52例再手术患者中既往手术史包括单纯胆囊切除20例,胆囊部分切除5例,胆囊切开取石1例,胆囊切除+胆道探查、T管引流20例,胆肠Roux en Y吻合3例,肝左叶部分切除2例,EST1例 结论胆道结石的术后复发,与结石的部位、胆道的病理改变、手术方式的选择、手术的合理操作、术者的经验、探查指征的掌握。

OBJECTIVE: To study the causes of re-operation in patients underwent operations for cacul: in biliary tract. METHODS: Analyze the past history of operations and follow-up data of the 52 patients admitted from January of 1997 to October 2001 with recurrent symptoms after operations for cholelithiasis. RESULTS: 52 patients included in this study, twenty accepted simple cholecystectomy, five partial cholecystectomy, one calculus removing with cholecystostemy, twenty cholecystectomy combined with biliary tract exploration and T-tube drainage, three Roux-en-Y common bile duct jejunum anastomosis, two partial excision of left hepatic lobe, and the last one EST. CONCLUSION: The recurrence of calculus in biliary tract correlates with multiple factors including the position of the calcul: the pathological changes of the biliary tract, operative method, the rationality of the operation, experience of the operator, the criterion of the indications for biliary exploration, the general situation of the patients, etc.