肝切除术治疗复杂性肝胆管结石(附82例报道)  

Clinical Application of Hepatectomy for Hepatolithiasis

作　　者：吴哲[1] 陈少华[2] 张小进[2] 魏炜明[2] 陈功财[2] 江艺[2] 

机构地区：[1]安徽医科大学福州总医院临床医学院,福建福州350025 [2]解放军南京军区福州总医院肝胆外科,福建福州350025

出　　处：《中国医药指南》2012年第20期407-408,共2页Guide of China Medicine

摘　　要：目的 探讨肝切除术治疗复杂性肝胆管结石的治疗效果及应用价值.方法 回顾性分析我院肝胆外科2005年1月1 日至2008年12月31 日采用肝切除术治疗复杂肝胆管结石患者的临床资料,统计结石的分布、手术方式及疗效.结果 术后并发症发生率14.6%（12/82）,包括胆瘘3例,腹腔脓肿2例,腹腔出血1例,胆道出血1例,切口感染及迁延愈合5例.统计术后2~4 周T 管造影资料,残石率为9.8% （8/82）.60例患者获得随访,随访率73.8%（60/82）,治疗效果优者占71.7%（43/60）.结石复发率13.3%（8/60）,胆管炎发病率10.0%（6/60）,术后胆道镜取石率6.7%（4/60）,病死率0%（0/84）.结论 肝切除术在治疗复杂性肝胆管结石中有着重要地位.Objeetive To explore the effect and value of hepatectomy in curing complicated hepatolithiasis. Methods The clinical data of 82 patients with hepatolithiasis who underwent hepatectomy from 2005-2008 were retrospectively analyzed. Stones distribution, operative modality and outcomes were examined. Results The postoperative complications occurred in 12 cases, including biliary fistula in 3 patients, peritoneal abscess in 2 patients, peritoneal hemorrhage in 1 patients, infection of incisional wound in 5 patient. Residual stones were found in 8 patients （9.8%） according to the T-tube Cholangiography. 60 cases （73.8%, 60/82） were followed-up. Residual stones were found in 8 patients （13.3%） , the rate of good long-term effect was 71.7% （4360） . The rate of AOSC was 10.0% （6/60） , the rate of operation through choledochoscope was 6.7% （4/60） , the mortality was 0% （0/60） . Conclusion Hepatectomy plays an important role in the curing of implicated hepatolithiasis.

关 键 词：肝切除术 肝胆管结石 回顾性研究 

分 类 号：R657.4[医药卫生—外科学]