肝切除术治疗肝内胆管结石疗效分析
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黄强E-mail:hq_sohu.com

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Hepatectomy for hepatolithiasis
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    摘要:

    目的:探讨肝切除对肝内胆管结石的治疗效果。
    方法:回顾性分析2000年6月至2007年7月收治的107例肝内胆管结石患者的临床资料,统计结石的分布、术式选择、术后并发症及治疗效果
    结果:全组107例,行左肝外叶切除80例,左半肝切除14例,右侧肝段(V,VI,VII,VIII)切除12例,右半肝切除1例。术后残石率为10.3%(11/107),经T管胆道镜及内镜下十二指肠乳头切开术(EST)处理后最终结石残余率3.7%(4/107)。术后并发症发生率为29.9%(32/107),其中左外叶切除、左半肝切除、右侧半肝切除及肝段切除的手术并发症分别为23.7%(19/80),42.8%(6/14),53.8%(7/13),后两者并发症率高于前者(P<0.05)。
    结论:肝切除治疗肝内胆管结石具有相对较低的残石率和结石复发率,是安全有效的。

    Abstract:

    Objective: To evaluate therapeutic effects of hepatectomy for hepatolithiasis.
     Methods: Retrospective analysis of the clinical data,including stones distribution, operative modality, postoperative complications, and therapeutic effect of hepatectomy for hepatolithiasis in 107cases admitted  in our hospital from June 2000-July 2007 was undertaken.
     Results: Among the 107 patients, left lateral lobectomy was performed in 80 cases, left hepatectomy  in 14 cases,  right hepatectomy in one case and selective combined segmentectomy in 12 cases.The postoperative residual stone rate was 10.3% (11/107 cases), but the final residual stone rate was 3.7% (4 /107 cases) after stone extraction by subsequent T-tube route or endoscopic sphincterotomy (EST). Postoperative complication rate was 29.9%(32  /107 cases), while in left lateral lobectomy, left hepatectomy, right hepatectomy and selective combined segmentectomy complications were 23.7% (19/80 cases), 42.8% (6/14 cases) and 53.8% (7/13 cases), respectively. The latter 2 procedures had a higher rate of complications than the former 2 procedures (P<0.05).
     Conclusions: Liver resection for intrahepatic bile duct stones has a relatively low rate of residual stones and stone recurrence, it is safe and effective.

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王世杰|黄强|谢放.肝切除术治疗肝内胆管结石疗效分析[J].中国普通外科杂志,2010,19(2):132-134.
DOI:10.7659/j. issn.1005-6947.2010.02.007

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  • 收稿日期:2009-04-23
  • 最后修改日期:2009-09-16
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  • 在线发布日期: 2010-02-15