摘要
目的:探讨肝内胆管结石的手术治疗及术后残石对策。方法:回顾性分析肝内胆管结石112例临床资料,行肝叶(段)切除术29例,肝叶(段)切除+胆管空肠Roux-en-y吻合术8例,肝叶(段)切除+胆总管切开取石术6例,胆总管切开取石+胆管空肠Roux-en-y吻合术20例,胆总管切开取石+T管引流术49例。结果:术后残石28例(25.0%),经胆道镜等技术取石后残石4例(3.6%),再次手术2例(1.8%)。结论:残石率为3.6%,解除梗阻,去除病因是治疗肝内胆管结石的基本原则,合理选择手术方式,术中和术后配合胆道镜治疗,可有降低残石率。
Objective： To investigate the surgical treatment of patients with intrahepatolithiasis and therapeutic strategy of residual stone. Methods： 112 patients with hepatolithiasis were reviewed and analyzed retrospectively. 29 cases received hepatotobectomy（hepatic segmentectomy）, 8 cases received hepatolobectomy （hepatic segmentectomy） plus Roux-en-Y cholangiojejunostomy, 6 cases received hepatolobectomy（hepatic segmentectomy） plus choledochotomy and calculus removal, 20 cases received hepaticolithotomy plus Roux-en-Y cholangiojejunostomy and simple choledochotomy and calculus removal plus T-tube drainaged were applied in 49 cases. Results： 28 cases （25%） had residual stone after surgical treatment, 4 cases （3.6%） had residual stone after calculus removed with choledochoscope, 2 cases （1.8%） received operation again. Conclusion： The rate of residual stone was 3.6%, It is essential to release Obstruction and remove the cause in the treatment of hepatolithiasis.The patterns of operation should be chosen according to different situation; and choledochoscope plays an important role in the improvement of surgical results and lowering of postoperative complication rate.
出处
《中国现代普通外科进展》
CAS
2009年第6期537-539,共3页
Chinese Journal of Current Advances in General Surgery
关键词
肝内胆管结石
外科手术
Intrahepatolithiasiso Intrahepatolithiasis, Surgical procedures, operative
