摘要
目的 :探讨孤立性左肝内胆管结石的外科治疗。方法 :归纳八年来 2 8例左肝内胆管结石行左肝叶、肝段及左半肝切除的临床资料及随访情况。结果 :18例结石局限于左肝外叶 ,行左肝外叶切除 +胆管T管引流术或胆管空肠R -Y吻合术 ,10例结石局限于左半肝且伴左半肝胆管严重狭窄、肝脓肿行左半肝切除 +胆管T管引流术。随访 1～ 7年 ,左外肝叶切除 18例 ,术后 4例结石复发 ,行胆道镜 1～ 3次取石 ;而行左半肝切除者无一例复发。整组病例无死亡。结论 :行左肝叶、肝段、左半肝切除是治疗左肝内胆管结石的首选方式 ,且安全可靠 ,近远期疗效良好。
Objective: To investigate the surgical treatment of concretion in separate bile duct in left liver. Methods: Summing up clinical material and regular postoperation observation of twenty-eight patients who suffer from concretion in bile duct in left liver and on whom the operations of resecting left liver leaf, liver segment, left liver were performed in succession during eight years. Results: The eighteen patients who have concretion in outside leaf in left liver underwent operation of resecting outside leaf in left liver with the drainage of bile duct with a T tube or Roux-en-Y anastomosis of anastomosing bile duct and jejunum. On the other ten patients who have concretion in left liver whose bile duct is seriously narrow and which suffers from abscess, the operation of resecting left liver with drainage of bile duct with a T tube were performed, One to seven years of regular postoperation observation show that, among the eighteen patients who underwent the operation of resecting outside leaf in left liver, four patients have a relapse of concretion and the endoscope of bile duct has to be used for one to three times to remove concretion, while 10 cases whose left livers have been completely resected have no replase, No death is found among the twenty-eight patients. Conclusion: Resecting left liver leaf, liver segment, left liver is the best method of removing concretion in the bile duct of left liver. The method is safe with immediate medical effect which can be seen for a long time.
出处
《河北医学》
CAS
2003年第9期790-791,共2页
Hebei Medicine
关键词
左肝结石
肝切除术
肝胆管狭窄
Concretion in left liver
Resecting liver
Narrow bile duct in liver
