肝胆管结石外科手术与疗效分析  

Analysis for surgical treatment of hepatolithiasis and the efficacy

作　　者：马森[1] 王瑞[1] 李伙新[1] 蒋悦葵 包福德[1] 

机构地区：[1]深圳市坪山人民医院普外科,广东省深圳518118

出　　处：《中国基层医药》2007年第12期1994-1995,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨肝胆管结石不同手术方式和疗效关系。方法回顾性分析1995年1月至2006年12月89例肝胆管结石采用外科治疗的术式和治疗效果。其中肝门胆管狭窄成形术33例,肝叶切除术7例,胆肠吻合术22例,胆总管切开取石T管引流术27例。结果术后有81例随访,随访6个月至12年。采取肝门胆管狭窄成形术残留结石率15.15%(5/33).术后胆管炎发生率12.50%(4/32),采取肝叶切除术方式残留结石率14.29%(1/7),术后胆管炎发生率16.67%(1/6),采取胆肠吻合术方式残留结石率18.18%(4/22),术后胆管炎发生率30%(6/20),采取胆总管切开取石T管引流术残留结石率33.33%(9/27),术后胆管炎发生率29.17%(7/24)。结论治疗肝胆管结石,采用肝门胆管狭窄成形术及肝叶切除术疗效较好。Objective To study the relationship between the choice of operation and the efficacy on hepa- tolithiasis. Methods From Januray of 1995 to December of 2006,89 patients with hepatolithiasis underwent surgical treatment were retrospectively analyzed. Of them 33 cases underwent hepaticoplasty, hepatolobectomy in 7 cases, cholangiojejunostomy in 22 cases,choledocholithotomy with T-tube drainage in 27 cases. Results Out of the 89 cases, follow-up was completed in 81 cases for 6 months to 12 years. The postoperative stone residual rate of the group which underwent hepaticoplasty was 15.15 % （5/33） and cholannitis recurrence rate was 12.50 % （4/32）, hepatolobectomy was 14.29% （1/7） and 16.67% （1/6） ,cholangiojejunostomy was 18.18% （4/22） and 30% （6/20）, choledocholithotomy with T-tube drainage was 33.33 % （9/27） and 29.17 % （7/24）. Conclusion Hepaticoplasty and hepatolobec＇comy were superior to cholangiojejunostomy and choledocholithotomy with T-tube drainage for treat- ment of hepatolithiasis.

关 键 词：肝胆管结石 胆道外科手术 治疗效果 

分 类 号：R657.4[医药卫生—外科学]