肝切除配合纤维胆道镜治疗肝胆管结石25例  

THE TREATMENT OF HEPATOLITHIASIS BY HEPATECTOMY AND CHOLEDOCHOFIBERSCOPE(25 CASES REPORT)

作　　者：张亚铭[1] 张从雨[1] 宋玉庆[1] 昝建宝[1] 嵇成祥[1] 汪东树[1] 马立[1] 房志宽[1] 

机构地区：[1]安徽省安庆市立医院普外科,安庆24600

出　　处：《肝胆外科杂志》2003年第5期357-358,共2页Journal of Hepatobiliary Surgery

摘　　要：目的　探讨肝胆管结石病人的最合理外科治疗。方法　回顾性分析 1996年 4月至 2 0 0 0年 2月手术配合纤维胆道镜治疗肝胆管结石 2 5例。结果　 2 5例肝胆管患者 ,左外叶切除 2 1例 ,左半肝切除 3例 ,右后叶切除 1例 ,3例同时附加胆总管空肠 Roux- en- Y端侧吻合 ,无手术死亡。术后结石残留 3例 ,经纤维胆道镜均顺利取出。结论　在经济欠发达地区肝胆管结石病人就诊时结石分布并不按严格的叶段分布 ;术中纤维胆道镜可以发现切除肝以外的散在结石 ,可大大降低结石残留率 ;Objective To explore the optimal treatment of hepatolithiasis.Methods The data from 25 cases with hepatolithias,who underwent hepatectomy and choledochofiberscope from Apr 1996 to Feb 2000,were retrospectively analyzied.Results 21 patients adopted hepatectomy for left lateral lobe,3 for left lobe and 1 for right posteriol lobe.An additional Roux en y choledochojejunostomy was performed for 3 patients.The operation mortality is nil.Residual calculi in 3 patients after operation were taken out smoothly by choledchofiberscope.Conclusion The intrahepatic calculi doesn't distribute with aratomic segments or lobes strictly.Residual calculi decrease greatly since scattered stones of removal liver are discovered by choledochofiberscope in operation.Hepatectomy to cure hepatolithiasis would probably prevent delayed cholangiocarcinoma.

关 键 词：肝胆管结石 肝切除 内窥镜 

分 类 号：R735.7[医药卫生—肿瘤]