摘要
目的 探讨不同类型的肝内胆管结石采取不同手术方式治疗的效果。方法 回顾分析1995年 3月～ 2 0 0 1年 3月间我院收治并手术治疗的肝内胆管结石 6 7例 ,其中合并肝胆管狭窄 44例(占 6 5 .6 7%)。分型 :中央型结石 2 4例 ,周围型结石 5例 ,全程局限型结石 34例 ,全程弥漫型结石 4例。手术方式 :肝叶段切除术 2 8例 ,肝门胆管切开取石、高位胆管空肠吻合术 2 1例 ,肝叶段切除、胆管空肠吻合术 18例。结果 6 4例获得 5个月～ 6年的随访 ,全组优良 5 8例 (占 90 .6 3%) ,差 9例 (占9.3%)。残余结石 17例 (占 2 6 .5 5 %) ,再手术 4例 (占 6 .2 5 %)。结论 肝内胆管结石病情复杂 ,应根据不同类型结石采取不同的手术方式 ,盲目扩大肝叶段切除适应证并不能提高手术治疗效果 ,而增加并发症的发生。
Objective To investigate the effectiveness of different procedures for the patients with different types of intrahepatic clolelith. Methods 67 cases of intrahepatic clolelith admitted from March 1995 to March 2001 were reviewed. Among them, 44 ( 65.6%) were complicated by bile duct stricture. Classification: centeral intraheptic clolelith (24 cases), peripheral intraheptic clolelith (5 cases), whole course of bile duct intraheptic clolelith (34 cases) and whole course of dispers intraheptic clolelith (4 cases). 28 cases were treated with hepatic segmentectomy, 21 with hilar choledochojejunostomy and 18 with hepatic segmentectomy and cholangiojunostomy. Results The total of 64 cases was followed up from 5 months to 6 years. Good to exellent rusults were found in 58 cases ( 90.63%). Residual stones were found in 17 cases ( 26.55%). Reoperation was performed in 4 cases ( 6.25%). Conclusions We must perform proper operation according to the types of intrahepatic clolelith and avoid enlarging the indications of hepatectomy.
出处
《腹部外科》
2002年第4期230-231,共2页
Journal of Abdominal Surgery
关键词
肝内胆管结石
治疗
外科手术
clolelithiasis
segmentectomy
hepatic
choledochojejunostomy
