肝实质切开取石治疗肝内胆管结石的临床应用及疗效分析  

Clinical application and efficacy of cut open liver parenchyma Lithotomy for intrahepatic bile duct stone

作　　者：何仕青 赵强 李铮宇 彭北生 

机构地区：[1]广东省台山市人民医院普通外科,广东台山529200

出　　处：《海南医学》2008年第7期17-18,共2页Hainan Medical Journal

摘　　要：目的分析经肝实质切开取肝内胆管结石的利与弊,探讨肝内胆管结石手术的最佳方法。方法对1998-2003年行肝实质切开取肝内胆管结石33例患者的临床资料进行分析。结果单纯肝实质切开取石8例,联合胆总管切开取石25例,术后发生胆汁漏4例,膈下脓肿3例,残留肝内胆管结石3例,结石复发14例。结论肝实质切开取石与最受推崇的肝叶段切除比较,结石取尽率相当,但结石复发率明显高于后者,适用于年老、心肺等重要器官功能不全患者,危重患者急诊手术,或不具备肝叶段切除手术条件的基层医院。Objective To analyze benefit and disadvantage of cut open liver parenchyma for intrahepatic bile duct stone, and explore preferred operation methods for intrahepatic bile duct stone. Methods The clinical data of 33 patients with cut open liver parenchyma for intrahepatic bile duct stone in our hospital from December 1998 to December 2003 were retrospectively analyzed. Results Of 33 patients , 8 patients＇s stone were removed through cut open liver parenchyma, 25 patients＇s stone were removed through cut open liver parenchyma and bile commen duct, 4 patients appearanced bile leakage, 3 patients appearanced subdiaphragmatic abscess, 3 patients appearanced stone residual and 14 patients appearanced stone recidivation. Conclusion To compare cut open liver parenchyma with hepatic segmental resection, residual stones rate was alike, but stones recurrence rate more than the latter, cut open liver parenchyma refer to senility and hyposthenia patient or emergency operation or basic level hospital.

关 键 词：肝实质切开取石 肝内胆管结石 结石残留 

分 类 号：R657.42[医药卫生—外科学]