伴有终末期胆病的复杂性肝内外胆管结石治疗方式的选择  

Selection of treatments for patients with cholelithiasis complicated with end biliary disease

作　　者：邢雪[1] 李洪[1] 胡义利[1] 王一[1] 

机构地区：[1]青岛市市立医院肝胆外科,266011

出　　处：《中华肝胆外科杂志》2008年第11期784-785,共2页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨伴有终末期胆病的复杂性肝内外胆管结石的手术时机和手术方式。方法对32例伴有终末期胆病的复杂性肝内外胆管结石施行了手术治疗，手术方式包括胆总管切开取石“T”管引流术，胆囊切除、胆总管切开取石“T”管引流术，胆囊切开取石、胆囊造口术、胆总管切开取石“T”管引流术，原位肝移植术。结果所有病人无手术死亡，术后并发症发生率为46．88％。术后疗效优7例，良14例，差11例。结论此类病人肝脏功能储备差，术中极易发生大出血，术后并发症发生率高。手术前应完善围术期处理，以简单术式为主，解决引起主要症状的结石。Objective To investigate the timing and procedures of operation for patients with cholelithiasis complicated with end biliary disease. Methods Thirty-two patients with cholelithiasis complicated with end biliary disease were surgically treated in our hospital. The operative procedures included choledochotomy with T tube insertion, cholecystectomy and choledochotomy with T tube insertion, cholecystectomy and choledochotomy with T tube insertion and hepatic transplantation. Results No operative death occurred and the incidence of complications was 46.8%. Seven patients were better, 14 good and 11 poor in therapeutic efficacy. Conclusion The patients can have major hemorrhage during operation for their poor hepatic function and high incidence of complications. Sire ple operative procedures should be used to mainly remove the stone causing the major symptoms.

关 键 词：胆结石 治疗 手术 肝功能 

分 类 号：R686[医药卫生—骨科学]