摘要
目的:探讨手术治疗肝胆管结石合并胆管狭窄的方法及临床疗效。方法:回顾性分析2008年1月—2012年11月收治的62例胆管结石合并胆管狭窄患者的临床资料,根据手术方法的不同分为观察组(44例)和对照组(18例)。观察组术中均行肝方叶切除,对照组采用未行肝方叶切除的手术方法。比较两组的临床疗效、术后的残石率、术后并发症、复发率以及治疗前后肝功能的变化。结果:两组均无病死病例。与对照组比较,观察组临床疗效的优良率高(93.2%vs.77.8%);残石率、并发症发生率、复发率均降低(9.1%vs.27.8%;9.1%vs.22.2%;2.2%vs.16.7%),组间差异均有统计学意义(均P<0.05)。两组术前肝功能酶学指标差异均无统计学意义(均P>0.05),出院时均较治疗前明显改善,但观察组各项指标的改善程度均优于对照组(均P<0.05)。结论:在手术治疗肝胆管结石合并胆管狭窄中进行肝方叶切除,能够提高手术疗效,降低残石率,改善患者的肝功能。
Objective： To investigate the method of surgical treatment and clinical efficacy of hepatolithiasis with bile duct stricture. Methods： The clinical data of 62 patients with hepatolithiasis concomitant with bile duct stricture treated between January 2008 and November 2012 were retrospectively analyzed. These patients were divided into observational group and control group according to the surgical methods used. All patients in observational group underwent caudate lobe resection during surger）5 while those in control group received surgical treatments without caudate lobe resection. The clinical efficacy5 incidence of postoperative residual stones and complications, recurrence and alterations of liver function before and after surgery between the two groups were compared. Results： No death occurred in either group of patients. In observational group compared with control group, the excellent rate of clinical efficacy was improved （93.2% vs. 77.8%）, the incidence of postoperative residual stones and complications as well as recurrence rate was significantly decreased （9.1% vs. 27.8%; 9.1% vs. 22.2%; 2.2% vs.16.7%）, and all the differences had statistical significance （all P〈0.05）. The preoperative liver function enzymes of the two groups showed no statistical difference （all P〉0.05）, and all were improved at time of hospital discharge, but all the enzyme parameters were improved significantly better in observational group than those in control group （all P〈0.05）. Conclusion： In surgical treatment of hepatolithiasis with bile duct stricture, caudate lobe resection can improve the surgical efficacy, reduce the rate of residual stones, and improve the liver function of these patients.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第2期178-181,共4页
China Journal of General Surgery
关键词
胆结石
胆管
肝内
缩窄
病理性
肝切除术
Cholelithiasis
Bile Ducts, Intrahepatic
Constriction, Pathologic
Hepatectomy
