摘要
目的：探讨左肝内胆管结石的治疗方法，提高手术切除率，降低手术风险系数。方法：回顾性总结63例左肝内胆管结石患者在常温下阻断左半肝血流，行左肝叶切除、肝内含石胆管直视下切开取石和肝胆管Roux—en—Y胆肠吻合等手术后，患者术后并发症、肝内胆管结石的复发率、再手术率以及术后患者的肝功能恢复情况等。结果：本组无手术死亡，治愈率82．4％，好转率17．6％，残石率8．3％。并发症23例，胆漏2例，膈下感染4例，切口感染9例，术后转氨酶升高6例，消化道出血2例，全部并发症经非手术治疗全愈。经1～8年随访，复查B超、CT、肝功等检查，随访率87．7％；复发6例，复发率9．52％。结论：该方法可以控制肝切除术中的失血，保留了健侧肝脏的血运，术中及术后对肝功能损伤较轻。是一种比较简单、可行、合理的肝血流阻断方法。
Objective： To investigate an optimum method for left hepatolith to improve the operation response. MeCh.： Sixty-three cases of left hepatolith underwent operations of left-half hepatectomy, Roux-en-Y cholangio-jejunostomy and removal of stones by cholangiotomy under the condition of hemihepatic blood flow occlusion at normal atmospheric temperature. The postoperative complications, the index of liver function, the recurrent rate and the re-operation rate were evaluated. Results： No one died during the operations and the postoperative recovery rate, the improvement rate and the residual rate were 82.4%, 17.6% and 8.3%, respectively. Complications were found in 23 cases, biliary fistula in 2 cases, subphrenic inffection in 4, incisional wound inffection in 9, transaminase lifting in 6 and digestive tract bleeding in 2, but they were all cured by non-operative treatment. During 1-8 years of follow-up, 87.7% of the cases were rechecked by ultrasonic diagnosis B, CT and liver function test, and 6 of them had relapsed. Conclusion： The hemihepatic blood flow occlusion for hepatectomy is a feasible, reasonable and effective procedure due to good control of blood loss, retention of blood circulation in the healthy liver side, and lessening of intra-operation and post-operation liver dysfunction.
出处
《山东大学学报（医学版）》
CAS
北大核心
2007年第1期106-108,共3页
Journal of Shandong University:Health Sciences
关键词
半肝血流阻断
左肝内胆管结石
手术
Half-hepatic blood flow occlusion
Left hepatolithiasis
Surgical procedures, operative
