摘要
目的：探讨急性梗阻性胆管炎行急诊胆总管探查并肝左外叶切除的治疗效果及安全性。方法采用回顾性描述性研究方法，收集2010年1月至2015年1月商洛市中心医院收治的37例急性胆总管探查合并行左外叶切除治疗肝内外胆管结石患者的临床资料。患者行急诊胆总管探查及肝左外叶切除术。观察指标：（1）患者手术情况。（2）主要并发症：术后胆漏、结石残留、术中出血情况。（3）术后患者的引流、结石残留及恢复情况。结果37例患者手术时间90～180 min，平均手术时间120 min，肝左外叶切除时间平均23 min，平均出血量80 mL，胆管结石残留3例，术中胆道出血3例，术后残端胆漏1例，术后病理检查回报肝内胆管癌1例。结论急诊行胆总管探查及肝左外叶切除是安全可行的手术方式，可以避免术中结石残留左叶，又可避免术后左外叶的再感染及结石再生。
Objective To investigate the therapeutic effect and safety of acute obstructive cholangitis under-went emergency exploration of common bile duct and left hepatic lobectomy.Methods A retrospective descriptive study was used.The clinical data of 37 cases of acute common bile duct exploration with left lateral lobectomy in the Central Hospital of Shangluo from January 2015 to January 2010 were collected.The patients received emergency common bile duct exploration and left lateral lobectomy of the liver.Outcome measures：（1）patients with surgery;（2） major complications：postoperative bile leakage,residual stones,intraoperative bleeding;（3）postoperative drainage, residual stones and recovery of patients.Results 37 patients was performed in 16 cases,the average operation time was 120min,hepatic left lateral lobe resection average 23min,average amount of bleeding was 80mL.Postoperative stump 1 case of bile leakage,bile duct stones residue in 3 cases,intraoperative bleeding in 3 cases,postoperative return pathology intrahepatic cholangiocarcinoma in 1 case.Conclusion Emergency treatment of common bile duct exploration and left lateral lobectomy is a safe and feasible surgical approach,which can avoid the the reinfection of left lateral lobe.
作者
凤利锋
李斌
梅勇
刘爱军
Feng Lifeng Li Bin Mei Yong Liu Aijun(Department of Hepatobiliary Surgery, the Central Hospital of Shangluo City, Shangluo,Shanxi 726000, Chin)
出处
《中国基层医药》
CAS
2016年第24期3742-3744,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
胆管炎
胆汁淤积
肝切除术
急诊处理
Cholangitis
Cholestasis
Hepatectomy
Emergency treatment
