右肝内胆管结石手术的应用解剖和临床研究  

Applied anatomy and clinic reseach in approach of lobar and segmental bile ducts of right liver

作　　者：王炳煌[1] 张小文[1] 张天玉[1] 李立春[1] 李晓[1] 朱红[1] 王华[1] 莫小华[1] 

机构地区：[1]昆明医学院第二附属医院肝胆胰外科

出　　处：《中华医学杂志》1997年第11期805-807,共3页National Medical Journal of China

基　　金：云南省科学技术委员会资助

摘　　要：探讨显露和切开右肝内各叶、段胆管的手术方法，更好地治疗右肝内胆管复杂多发结石并狭窄的病人。方法从肝内胆管手术的角度，仔细观察了３０个成人肝标本的肝内各叶、段胆管与血管解剖关系。认为右肝内各叶段胆管显露和切开，应从肝脏膈面经肝实质进路为佳。用于临床手术治疗右肝内胆管为主的复杂多发结石并多处胆管狭窄１０例。结果全组手术成功，治愈出院。随访６个月至３６个月，优良８０％，好转２０％。结论经肝脏膈面切开肝实质进路，可以显露和切开右肝内各叶、段胆管，取出结石，解除狭窄。bjective To Study the operative approach and the method of exposure and cutting open for every lobar and segmental bile ducts and solve the surgical treatment of the complex multiple stones complicated with bile ducts stenosis in the right liver. Methods Liver specimens of 30 adults were dissected to explore the lobar and segmental bile ducts and vessels. The exposure and cutting open of right intrahepatic bile ducts were well from the diaphragmatic face of the right hepatic lobe. This method was used in 10 patients with the disease. Results All the patients were succesfully treated. Followup for 336 months, showed that 80% patients had excelent results, and 20% good ones. Conclusion The exposure and cutting open of the intrahepatic bile ducts from the diaphragmatic face of the right liver may take stones and solve bile duct stenosis in the every lobes and segment of the right liver.

关 键 词：胆管结石 肝内胆管 外科手术 解剖学 

分 类 号：R657.420.5[医药卫生—外科学] R322.48[医药卫生—临床医学]