摘要
目的 分析肝切除治疗肝胆管结石的疗效。方法 报告 1975年至 1999年 11月 6 44例肝内胆管结石病人采用肝切除治疗的术式、并发症及随访情况。结果 本组治疗方式中合并的肝切除率为 5 2 % ;6 44例中 ,6 2 9%经历过 1～ 5次手术 ,其中 2 0 5 %合并不同类型的胆肠吻合。肝切除术式 :左外叶切除 378例 (5 8 7% ) ;左半肝切除 132例 (2 0 5 % ) ;右半肝切除 31例 (4 8% ) ;多段切除 6 6例 (10 3% ) ;肝方叶切除作为附加术式 37例 (5 7% ) ;手术并发症 12 2例 (18 9% ) ,包括暂时性胆瘘、断面及膈下感染、胆道出血等 ;死亡 10例 (1 5 % )。 5 5 6例 (86 0 % )获平均随访 15 5年 ,优良率 88%。结论 强调必须根据临床病理类型及病因学决定术式 ;肝叶段切除为治疗原则中的核心。
Objective To analyse curative effects of lobectomy and segmental resection of liver for intrahepatic bile duct stones. Methods Six hundred and forty four patients suffering from intrahepatic bile duct stones and having undergone lobectomy and segmental resection from 1975 to Nov. of 1999 were analysed. Results In these 644 patients 62.9% underwent 1 to 5 operations, including different types of cholangioduodenostomy (20.5%). The types of hepatectomy, included left lateral hepatectomy (378 cases, 58.7%), left hemihepatectomy (132 cases, 20.5%), right hemihepatectomy (31 cases, 4.8%), multiple segmental resections (66 cases, 10.3%), and different hepatectomies combined with quadrate lobectomy (37 cases, 5.7%). Postoperative complicatons occurred in 18.9% cases, including transient biliary fistula, hemobilia, and subdiaphragmatic and resectional surface infections. Ten patients (1.5%) died. Eighty six percent of the patients were followed up for an average of 15.5 years and excellent result of 88% was achieved. Conclusions The authors emphasize that hepatic lobectomy and segmental resection are the core of treatment and selection of operative method depends on clinico pathologic types of the disease.
出处
《中华肝胆外科杂志》
CAS
CSCD
2000年第3期175-177,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
肝内胆管结石
肝切除术
临床病理
类型
Intrahepatic bile duct Hepatectom Clinical pathologic types
