肝胆管结石多次胆道术后再手术对策  

Hepatobiliary stones are countermeasures for multiple biliary tract surgery after surgery

作　　者：尹新民[1] 蔡成之 朱斯维[1] YIN Xin-min;CAI Cheng-zhi;ZHU Si-wei(Department of Hepatobiliary Surgery,Hunan Provincial People's Hospital,the First Affiliated Hospital of Hunan Normal University,Changsha 410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学第一附属医院)肝胆胰微创外科,湖南长沙410005

出　　处：《中国实用外科杂志》2024年第3期273-277,共5页Chinese Journal of Practical Surgery

基　　金：湖南省科技厅项目(No.2017SK2144)。

摘　　要：肝胆管结石疾病具有高残留率、高复发率以及高并发症发生率的特点。由于肝胆管结石本身的特殊性、首次治疗措施的不当或医源性损伤等因素,相当一部分病人需要接受多次手术治疗。再次手术的复杂性及其并发症发生率均明显高于初次手术。治疗肝胆管结石疾病的主要方法为外科手术,包括传统开放手术、腹腔镜手术及机器人辅助手术。其手术方式多样化,包括胆管切开取石、肝切除、胆管狭窄修复成形、胆肠内引流,甚至肝移植等。此外,消化内镜和经皮经肝胆道镜(PTCS)是上述治疗方式的有效补充,有助于提高其治疗效果。Hepatobiliary duct stone disease is characterized by a high residual rate,high recurrence rate,and high incidence of complications.Due to the distinctiveness of hepatobiliary stones and inappropriate initial treatment measures or iatrogenic injuries,a significant number of patients require multiple surgical interventions.The complexity of the reoperation and the incidence of postoperative complications are significantly higher than those of the initial surgery.The main treatment for hepatobiliary duct stone disease is surgical,including traditional open surgery,laparoscopic surgery,and robot-assisted surgery.The surgical methods are diverse,including cholangiotomy for stone removal,hepatectomy,repair and reconstruction of biliary stricture,internal biliary-intestinal drainage,and even liver transplantation.In addition,digestive endoscopy and percutaneous transhepatic cholangioscopy(PTCS)serve as effective supplements to the above treatments,contributing to improve therapeutic outcomes.

关 键 词：肝胆管结石 多次手术 再手术 

分 类 号：R6[医药卫生—外科学]