胆石病5582例统计分析  

ANALYSIS OF 5 582 CASES ON CHOLELITHASIS

作　　者：李缨来[1,2,3,4,5,6,7,8,9] 崔新中 李宁[1,2,3,4,5,6,7,8,9] 尹方龙[1,2,3,4,5,6,7,8,9] 雷庭 李涛[1,2,3,4,5,6,7,8,9] 杨汉新[1,2,3,4,5,6,7,8,9] 郭启仁 叶建东[1,2,3,4,5,6,7,8,9] 杨忠惠[1,2,3,4,5,6,7,8,9] 雷正明[1,2,3,4,5,6,7,8,9] 

机构地区：[1]华西医科大学附属第一医院普外科 [2]四川省资阳市人民医院 [3]四川省南充地区医院 [4]四川省邛崃市人民医院 [5]成都市第一人民医院 [6]成都市新华医院 [7]四川省仁寿县人民医院 [8]南京军区福州总医院普外科 [9]泸州医学院附院

出　　处：《中国普外基础与临床杂志》1998年第4期228-230,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：对１９９０年１月～１９９５年１２月６年间我国部分省市区４６所医院收治的胆石病患者５５８２例进行统计分析。５５８２例中男１６９８例，女３８８４例，男∶女＝１∶２．２９；年龄１５～８４岁，平均４７．２岁。胆囊结石２７３５例（４８．９９％），其中单纯胆囊结石２２４８例（４０．２７％），合并胆总管结石４８７例（８．７２％）；伴急性胆囊炎５４例（１．９７％），急性胆管炎１８９例（６．９１％），阻塞性黄疸２１５例（７．８６％）。肝内外胆管结石２８４７例（５１．００％），其中肝外胆管结石１２８４例（２３．００％），左肝胆管结石６６８例（１１．９７％），右肝胆管结石３８４例（６．８８％），左右肝胆管结石５１１例（９．１５％）；合并急性重症胆管炎６８３例（２３．９９％），急性胆管炎１１６９例（４１．０６％），阻塞性黄疸４３１例（１５．１４％），胆汁性肝硬变２７８例（９．７６％）。胆囊结石组行单纯胆囊摘除术２６９７例（均为开腹手术），其中４８例加作Ｔ管引流；行胆肠吻合术３６例；Ｏｄｄｉ’ｓ括约肌成形术７例。胆管结石组行胆总管探查、取石及Ｔ管引流２２７５例（７９．９１％），行各类型胆肠吻合术５３４例（１０．７６％）；Ｏｄｄｉ’ｓ?Five thousands five hundreds and eighty two patients with cholelithasis in 46 hospitals were collected through questionnaire and analysed, of which 2 735 cases were gallstones (accounted for 48.99%),and 2 847 cases were intra and extrahepatobiliary tract stones (accounted for 51.00%). In the gallstone group, there were 487 cases (8.72%) complicated with choledocholithasis, 54 cases (1.97%) complicated with acute cholecystitis, 189 cases (6.91%) with acute cholangitis, and 215 cases (7.86%) with obstructive jaundice. In 2 847 cases with intra and extrahepatobiliary tract stones, 1 284 cases were found to be extrahepatic duct stones (23.00%), 668 cases were left intrahepatic duct stones (1.97%), 384 cases were right intrahepatic duct stones (6.88%), and 511 cases stone in both sides (9.15%); complications in this group were acute severe cholangitis 683 cases (23.99%), acute cholangitis 1 169 cases (41.06%), obstructive jaundice 431 cases (15.14%), and biliary cirrbosis 278 cases (9.76%). The operative procedure for patients with gallstones were cholecystectomy (2 697 cases), chelangioduodenostomy or cholangiojejunostomy (36 cases), and Oddi's sphincteroplasty (7 cases); and for patients with intra and extrahepatobiliary tract stones were choledocholithotomy and T tubule drainage (2 275 cases), differecnt forms of choledochoenterostomy (534 cases), and Oddi's sphincteroplasty (38 cases). The postoperative complicatioin rate in patients with gallstones was 1.13%, with intra and extrahepatobiiary tract stones was 14.47%, mortality of the latter was 1.62%. The authors consider that cholecystectomy should be performed in elderly patients (over 50 years) with or without symptoms, and proper choice of operative procedure for hepatobiliary tract stones is important.

关 键 词：胆囊结石 胆管结石 外科手术 胆结石 

分 类 号：R657.420.5[医药卫生—外科学]