腹腔镜循肝中静脉半肝切除联合经肝管取石术在复杂肝内胆管结石中的应用  

The application of laparoscopic middle hepatic veinguided anatomical hepatectomy combined with transhepatic duct lithotomy to the treatment of complex hepatolithiasis

作　　者：黄龙[1] 陈实[1] HUANG Long;CHEN Shi(Department of Hepatobiliary and Pancreatic Surgery,Fujian Provincial Hospital Fujian Medical University Provincial Clinical College,Fuzhou University Affiliated Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院肝胆胰外科福建医科大学省立临床医学院福州大学附属省立医院,福建福州350001

出　　处：《中国实用外科杂志》2024年第8期941-946,共6页Chinese Journal of Practical Surgery

基　　金：福建省卫生健康中青年领军人才研修培养项目。

摘　　要：肝内胆管结石病理特征复杂,狭窄扩张的胆管在肝内蔓延交织,难以完整切除,这导致术后结石残留率和复发率高。在长期实践过程中发现肝中静脉为左或右肝病变胆管天然界线,以肝中静脉为解剖学标志可彻底切除病变胆管。应用腹腔镜循肝中静脉半肝切除联合经肝管取石术可有效解除狭窄,降低结石的残留率和复发率,可达到“去除病灶、取尽结石、矫正狭窄、通畅引流、防治复发”的目的。Hepatolithiasis is a common biliary disease in China,characterized by complex pathology.The intertwined and dilated bile ducts spread throughout the liver,making it difficult to resect completely,resulting in a high rate of postoperative stone residuals and recurrence.Through long-term practice,our team has found that the middle hepatic vein serves as a natural boundary for the left or right diseased bile ducts,and the diseased bile ducts can be thoroughly excised with the middle hepatic vein as the anatomical mark.Therefore,this paper systematically summarizes the clinical application of laparoscopic middle hepatic vein-guided anatomical hemihepatectomy combined with transhepatic duct lithotomy,which can effectively relieve stenosis,reduce the residual rate and recurrence rate of stones,and achieve the objectives of“eliminating the lesion,removing all stones,correcting strictures,ensuring smooth drainage,and preventing recurrence.”

关 键 词：腹腔镜肝切除 肝胆管结石 循肝中静脉 经肝管取石 

分 类 号：R6[医药卫生—外科学]