肝左外叶切除术联合胆道镜胆总管探查取石术治疗左肝内胆管结石的临床效果  

Clinical effect of left lateral hepatectomy combined with choledochoscopic common bile duct exploration and lithotomy in the treatment of left intrahepatic bile duct stones

作　　者：高景雷 王连才[2] 田玉伟[2] GAO Jinglei;WANG Liancai;TIAN Yuwei(No.1 General Surgery Department,People's Hospital of Zhecheng,Shangqiu 476200;Hepatobiliary Surgery Department,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]柘城县人民医院普外一科,河南商丘476200 [2]河南省人民医院肝胆外科,河南郑州450003

出　　处：《临床医学研究与实践》2022年第7期82-84,共3页Clinical Research and Practice

摘　　要：目的探讨肝左外叶切除术联合胆道镜胆总管探查取石术治疗左肝内胆管结石的临床效果。方法选取我院收治的60例左肝内胆管结石患者进行回顾性分析,按照治疗方案将其分为观察组(30例,肝左外叶切除术联合胆道镜胆总管探查取石术)和对照组(30例,胆道镜胆总管探查取石术)。比较两组的手术情况、术后并发症发生情况、结石取净率、症状评分、生活质量评分及复发率。结果观察组的手术时间长于对照组,术中出血量多于对照组(P<0.05)。观察组的结石取净率高于对照组(P<0.05)。手术后,观察组的腹痛、发热、黄疸评分均低于对照组,生活质量各项评分均高于对照组(P<0.05)。观察组的术后1、2年复发率均低于对照组(P<0.05)。结论肝左外叶切除术联合胆道镜胆总管探查取石术治疗左肝内胆管结石可提高结石取净率,利于患者的预后。Objective To investigate the clinical effect of left lateral hepatectomy combined with choledochoscopic common bile duct exploration and lithotomy in the treatment of left intrahepatic bile duct stones.Methods A retrospective analysis of 60 patients with left intrahepatic bile duct stones admitted in our hospital were selected and divided into observation group(30 cases,left lateral hepatectomy combined with choledochoscopic common bile duct exploration and lithotomy)and control group(30 cases,choledochoscopic common bile duct exploration and lithotomy)according to the treatment plan.The operation status,occurrence of postoperative complications,stone removal rate,symptom score,quality of life score and recurrence rate were compared between the two groups.Results The operation time in the observation group was longer than that in the control group,and the intraoperative blood loss volume was more than that in the control group(P<0.05).The stone removal rate in the observation group was higher than that in the control group(P<0.05).After operation,the scores of abdominal pain,fever,and jaundice in the observation group were lower than those in the control group,and quality of life scores were higher than those in the control group(P<0.05).The recurrence rate in the observation group at 1 and 2 years after operation was lower than that in the control group(P<0.05).Conclusion Left lateral hepatectomy combined with choledochoscopic common bile duct exploration and lithotomy in the treatment of left intrahepatic bile duct stones can increase the stone removal rate and benefit the prognosis of patients.

关 键 词：左肝内胆管结石 肝左外叶切除术 胆道镜 胆总管探查取石术 

分 类 号：R657.4[医药卫生—外科学]