左半肝切除治疗左肝内胆管结石40例分析  

Left hepatectomy for left-side intrahepatic lithiasis： a report of 40 cases

作　　者：陈德烽[1] 韩明瑞[1] 陈宇峰[1] 刘泉源[1] 郭钟容[1] 

机构地区：[1]福建医科大学附属漳州市医院肝胆外科,363000

出　　处：《临床外科杂志》2013年第7期518-519,共2页Journal of Clinical Surgery

摘　　要：目的总结左肝内胆管结石行左半肝切除的体会。方法40例左肝内胆管结石行左半肝切除。术中采用不解剖第一肝门的左半肝肝蒂的选择性入肝血流阻断法，先切肝后胆总管切开，同时将肝断面与尾状叶缝合。结果术中平均失血（620．4±127．6）ml，术后3d创面引流量（76．8±14．6）ml／d，术后胆瘘3例，平均住院时间（16．4±3．8）d。术后T管造影结石残留率10％。结论左肝内胆管结石，最好的手术方式是切除左半肝，采用不解剖第一肝门的左半肝血流阻断，先切肝后切开胆总管，同时将肝断面与尾状叶缝合是一种安全有效的方法。Objective To summarise the experience of left hepatectomy for left-side intrahepatic lithiasis. Methods A total of 40 cases of left-side intrahepatic lithiasis were underwent left hepatectomy. During the procedure, the corresponding inflow vessels were ligated without dissecting porta hepatis. The common bile duct was incised after the hepatectomy and the liver section was sutured to the caudate lobe. Results Intraoperative blood loss was （620.4±127.6） ml and postoperative drainage volume of wound surface in three days was 76.8 ± 14.6ml per day. Bile leakage occurred in 3 cases. The mean hospital stays was 16.4±3.8 days. Postoperative T-tube cholangiography showed the residual stone rate was 10%. Conclusion Left hepatectomy was the best operation modality for left side intrahepatic lithiasis,this method, which ligated the corresponding inflow vessels without dissecting porta hepatis, incised common bile duct after hepatectomy, and sutured the liver section to caudate lobe,is safe and effective.

关 键 词：左肝内胆管结石 左半肝切除 

分 类 号：R575.62[医药卫生—消化系统]