肝胆管结石病的临床分型与手术方式选择  

Clinical classification of hepatolithiasis and choice of surgical strategy

作　　者：吕文平[1] 

机构地区：[1]解放军总医院肝胆外科,北京100853

出　　处：《临床肝胆病杂志》2013年第6期404-406,410,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81170429);北京市自然科学基金(7132191)

摘　　要：手术是治疗肝胆管结石病的主要手段,但是我国许多医疗机构对肝胆管结石病的手术方式选择很是不规范,导致肝胆管结石病术后结石残留率和复发率居高不下。本文认为肝胆管结石病的临床分型对肝胆管结石病手术方式的选择具有重要的临床价值,根据临床经验,分别对肝切除术、胆肠吻合术、胆管切口取石术以及肝移植治疗肝胆管结石病的适应症予以阐述。同时,将解放军总医院应用肝切除治疗肝胆管结石的手术技巧以及解剖性肝切除治疗肝胆管结石病的创新技术予以简述。Surgery is the first - line treatment for hepatolithiasis, but the choice of surgical strategy does not meet the criteria in many medical institutions in China, resulting in high residual stone rate and recurrence rate among patients with hepatolithiasis after surgery. We think clinical classification of hepatolithiasis is great clinical significance for the choice of surgical strategy. This paper reviews the indications for hepatectomy, choledochoenterostomy, bile duct exploration anti stone extraction, and liver transplantation in hepatolithiasis according to our clinical experiences. In addition, this paper gives a brief introduction to the surgical skills of hepatectomy and innovative technology of anatomical hepatectomy for treating hepatolithiasis in Chinese PLA General Hospital.

关 键 词：胆结石 外科手术 肝切除术 

分 类 号：R657.42[医药卫生—外科学]