肝内胆管结石92例手术治疗分析
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章庆华

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Surgical treatment of hepaticolithiasis:a report of 92 cases
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    目的:探讨肝内胆管结石手术治疗方法和时机对疗效的影响。方法:回顾性分析手术治疗92例肝内胆管结石的临床资料。结果:(1)术后并发症发生率14.1%(13/92),其中术中使用胆道镜者9.3%(4/43),未使用胆道镜18.4%(9/49),急诊手术组36.0%(9/25),择期手术组6.0%(4/67)。(2)术后胆道残余结石率22.9%(21/92), 使用胆道镜者13.9%(6/43),未使用胆道镜组30.6%(15/49);急诊手术组9/25例(36.0%),择期手术组17.9%(12/67例) 。(3)1例于术后2d死于ACST。全部病例随访4~10年,疗效优良为87%(80/91)。结论:合理的手术方式,配合胆道镜,适时的手术时机,可明显提高肝内胆管结石的疗效,减少并发症的发生。

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    Abstract:Objective:To assess the therapeutic effect and opportune time of surgical treatment of hepaticolithiasis. Methods:The clinical data of 92 patients with hepaticolithiasis who underwent surgical treatment were analyzed retrospectively. Results:(1) The incidence of postoperative complications was 14.1%(13/92 cases), in choledochoscopy group it was 9.3%(4/43 cases) and in the noncholedochoscopy group 18.4%(9/49 cases) ; in the emergency operation group it was 36%(9/25 cases) and in selective operation group 5.97%(4/67 cases) . (2) The incidence of residual stones was 22.9%(21/92 cases); in choledochoscopy group it was 13.9%(6/43 cases) and the noncholedochoscopy group 30.6%(15/49 cases); in emergency surgery group it was 36%(9/25 cases) and in selective operation group 17.9%(12/67 cases).(3)One pationt died from ACST two days after operation. All of the patients were followed up for 4-10 years; there were 80 cases (86.9%) who had a good therapeutic outcome. Conclusions:Logical surgical procedure associated with choledochoscopy and appropriate timing of surgical intervention can markedly improve the effect of surgical treatment of hepaticolithiasis and reduce the incidence of postoperative complications.

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章庆华,刘广成,沈建生,袁正,黄勇波.肝内胆管结石92例手术治疗分析[J].中国普通外科杂志,2005,14(1):2-.
DOI:10.7659/j. issn.1005-6947.2005.01.002

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  • 在线发布日期: 2005-01-25