摘要
目的:探讨精准肝切除术对于治疗复杂性肝胆管结石的临床效果。方法:回顾性分析近2年间接受精准肝切除术治疗的60例复杂性肝胆管结石患者的临床资料。结果:全组患者手术均顺利完成,平均手术时间为(358.60±45.6)min,术中出血量为(598.2±95.6)mL,术后住院时间为(12.5±2.7)d。术后发生并发症11例(18.3%),其中切口感染5例(8.3%),胆瘘1例(1.7%),右侧胸腔积液3例(5.0%),肺部感染2例(3.3%)。术后随访2个月至2年,残留结石3例(5.0%),经T管纤维胆道镜取净结石;2例(3.3%)复发,再次行内镜下十二指肠乳头括约肌切开术(EST)(再次手术率3.3%)取净结石。结论:精准肝切除术可有效降低残石率、复发率和再次手术率,是治疗复杂性肝胆管结石的有效方法。
Objective： To investigate the clinical efficacy of precise hepatectomy for complicated hepatolithiasis. Methods： The clinical data of 60 patients with complicated hepatolithiasis undergoing precise hepatectomy within the last two years were retrospectively analyzed. Results： The operations were performed successfully in all patients. The average operative time was （3S8.60±45.6） min, intraoperative blood loss was （$98.2±95.6） mL and length of postoperative hospital stay was （12.S±2.7） d. Postoperative complications occurred in 11 cases （18.3%） and included 5 cases （8.3%） of wound infection, 1 case （1.7%） of bile leakage, 3 cases （5.0%） of right pleural effusion, and 2 cases （3.3%） of lung infection. During the follow-up period of 2 months to 2 years, residual stones were found in 3 patients （5.0%）, which were removed by choledochofiberscope through T-tube sinus tract, and recurrence occurred in 2 patients （3.3%） who were treated again by endoscpic sphincterotomy （EST） to extract stones.Conclusion： Precise hepatectomy is effective for treatment of complicated hepatolithiasis, which can reduce the rate of residual and recurrent stones and reoperation.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2013年第2期131-134,共4页
China Journal of General Surgery
关键词
胆结石
外科学
胆管
肝内
肝切除术
方法
Cholelithiasis/surg
Bile Ducts, Intrahepatic
Hepatectomy/methods
