引用本文:黄效廷,仇慧模.肝内外胆管多发结石的手术治疗体会[J].中国临床新医学,2011,4(4):335-337.
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肝内外胆管多发结石的手术治疗体会
黄效廷,仇慧模
535400 广西,灵山县人民医院普外科
摘要:
[摘要] 目的 比较胆总管切开并左肝外叶切除联合取石术和单纯行胆总管切开取石术两种方法治疗肝内外胆管多发结石的效果。方法 选择91例肝内外胆管结石患者同期分为A、B两组,A组48例,采用胆总管切开取石、肝左外叶切除和T管引流术的方法;B组43例,采用胆总管切开取石和T管引流术的方法,对两组的术后结石残留复发率进行分析总结。结果 两组均顺利完成手术。A组术后残石率为29.2%,两年内复发率为12.5%;B组术后残石率为69.7%,两年内复发率为39.5%。A组患者在术后残石率、复发率方面明显低于B组,差异有统计学意义(P<0.05)。结论 加行肝左外叶切除术治疗肝内外胆管结石能取得比较好的临床效果,其术后残石率及结石复发率低于单纯行胆总管切开取石术。
关键词:  肝内外胆管结石  肝叶切除  残石率
DOI:10.3969/j.issn.1674-3806.2011.04.18
分类号:R 575.7
基金项目:
Experience on surgical treatment in the patients with intra- and extra-hepatic multiple bile duct calculi
HUANG Xiao-ting,QIU Hui-mo
Department of General Surgery,Lingshan County People′s Hospital, Guangxi 535400,China
Abstract:
[Abstract] Objective To compare the effect of section of common bile duct and calculus remove plus left lateral lobectomy of liver with that of section of section of common bile duct and calculus remove only in the treatment of patients with intra- and extra-hepatic multiple bile duct calculi.Methods The clinical data of 91 patients with intra- and extra-hepatic multiple bile duct calculi were restrospectively analyzed. These patients were divided into two groups and treated by two methods of surgical treatment in the same period. A group (48 patients) were treated by section of common bile duct and calculus remove,left lateral lobectomy of liver and drainge with T-tube; B group (43 patients) were treated by section of common bile duct,calculus remove and drainge with T-tube.The rate of residual calculus and the relapse rate of calculus after surgical treatment were analyzed.Results The operations in two groups were successfully completed. The rate of residual calculus after surgical treatment and the relapse rate of calculus within two years after surgical treatment were 29.2% and 12.5% respectively in A group,69.7% and 39.5% respectively in B group.The rate of residual calculus and the relapse rate of calculus after surgical treatment in A group were lower than those in B group (P<0.05﹚.Conclusion The clinical effect of the section of common bile duct and calculus remove plus left lateral lobectomy of liver in the treatment of patients with intra- and extra-hepatic multiple bile duct calculi is better,its rate of residual calculus and relapse rate of calculus after surgical treatment are lower than those of the section of common bile duct and calculus remove only.
Key words:  Intra- and extra-hepatic bile duct calculi  Lobectomy of liver  Rate of residual calculus