肝段切除术治疗左肝外叶结石21例临床分析  

Hepatic segment resection in the treatment of cholangetic calculus in the left lateral liver:A clinical analysis of 21 cases

作　　者：陈楠[1] 邬林泉[1] 袁荣发[1] 冯潜[1] 殷中强[1] 殷香保[1] 雷钧[1] 邵江华[1] 周涛[1] 黄勇[1] 

机构地区：[1]南昌大学第二附属医院肝胆外科,江西南昌330006

出　　处：《中国实用外科杂志》2016年第12期1318-1321,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81560396)

摘　　要：目的探讨肝Ⅱ段或Ⅲ段切除术治疗左肝外叶结石的临床效果。方法回顾性分析南昌大学第二附属医院2013年6月至2016年2月收治的21例左肝外叶结石病人的临床资料，肝内胆管结石均局限于肝Ⅱ段或Ⅲ段。手术方法为解剖性肝Ⅱ段或Ⅲ段切除。结果病人均康复出院。21例病人随访18（2～32）个月，1例左肝结石残余。其余病例通过B超、CT或MRI检查未发现胆管炎及结石复发迹象。结论对于肝内结石局限于肝Ⅱ段或Ⅲ段胆管，而其他肝段胆管未见原发性结石及狭窄，应行解剖性肝Ⅱ段或Ⅲ段切除，不应该盲目切除左肝外叶。Objective To investigate the clinical effect of hepatic Ⅱ segment or Ⅲsegment resection in the treatment of cholangetic calculus in the left lateral liver. Methods The clinical data of 21 cases of cholangetic calculus in the left lateral liver admitted from June 2013 to February 2016 in the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. The hepatolithiasis were limited to section Ⅱ or section Ⅲof the liver. The surgical methods were anatomical hepatic Ⅱsegmentectomy or m segmentectomy. Results All the cases recovered and were discharged. A total of 21 cases were followed up in 18（2-32）months, during which residual calculi of left liver happened in 1 case, and other cases showed no sign of recurrent calculus and cholangitis through ultrasound, CT or MRI examination. Conclusion For hepatic calculus limited to bile ducts of hepatic Ⅱ segment or hepatic Ⅲ segment, while other hepatic bile ducts have no primary stones and stenosis, anatomical hepatic Ⅱsegmentectomy or m segmentectomy should be performed rather than left lateral liver resection blindly.

关 键 词：肝脏 左肝外叶结石 肝段切除术 

分 类 号：R6[医药卫生—外科学]