留置皮下通道多术式联合治疗肝内胆管结石  

Treatment of hepatolithiasis and its recurrence by combination of biliary stricture repair and partial hepatectomy with preservation of subcutaneous tunnel

作　　者：徐智[1] 王立新[1] 侯纯升[1] 凌晓锋[1] 张同琳[1] 周孝思[1] 

机构地区：[1]北京大学第三医院外科,100083

出　　处：《中华消化外科杂志》2008年第1期28-30,共3页Chinese Journal of Digestive Surgery

摘　　要：目的 探讨留置皮下通道、多种术式联合应用治疗肝内胆管结石及再发结石的效果。方法 回顾性分析我院1993年4月至2007年11月收治的116例采用留置皮下通道、狭窄纠正、病肝切除联合治疗肝内胆管结石及再发结石患者的临床资料。结石位于左半肝占23．3％（27／116），右半肝占13．8％（16／116），同时位于左、右半肝占62．9％（73／116）。结石合并狭窄占69．0％（80／116）。结果 108例获得随访，中位随访时间6．2年。随访患者中胆管炎发作占13．9％（15／108）；再发结石占23．1％（25／108）；新发现胆管狭窄占8．3％（9／108）。通过皮下通道切开引流取石占25．0％（27／108）。结论 留置皮下通道、多种术式联合应用治疗肝内胆管结石及再发结石安全、有效、微创、简便。Objective To assess the efficacy of combination of biliary stricture repair and partial hepatectomy with preservation of subcutaneous tunnel in treating hepatolithiasis. Methods A retrospective analysis was done based on 116 patients with hepatolithiasis who underwent biliary stricture repair and partial hepatectomy with preservation of subcutaneous tunnel. Of all, 27 patients had stone in the left lobe （23.3%） , 16 in the right lobe （ 13.8% ） and 73 in bilateral lobes （62.9%）. Eighty patients had hepatolithiasis combined with biliary stricture （69.0%）. Results A total of 108 patients were followed up with a median time of 6.2 years. The rate of patients with cholangitis, stone recurrence, biliary stricture newly detected was 13.9% （15/108）, 23.1% （25/108） and 8.3% （9/108）, respectively. Draining inflammatory bile and taking out stones through subcutaneous tunnel were carried out on 27 patients （ 25.0% ）. Conclusions Treatment of hepatolithiasis and its recurrence by combination of biliary stricture repair and partial hepatectomy with preservation of subcutaneous tunnel is safe, effective, minimally invasive and easy to manipulate.

关 键 词：胆石症 肝内胆管 皮下通道 

分 类 号：R657.42[医药卫生—外科学]