摘要
目的 研究近年来原发性肝胆管结石的手术治疗方式及治疗效果。方法 回顾性分析近 10年来手术治疗原发性肝胆管结石 5 0 4例的临床表现、治疗方法及疗效。结果 5 0 4例中行肝切除治疗 2 80例 (占5 5 8% )。全组术后残石率为 3 4 6% ,肝切除组和非肝切除手术组之间残石率差异显著 ,有统计学意义 ( 2 1 7%vs 5 3 7% ,P <0 0 1) ,围手术期并发症差异无统计学意义 ( 5 7%vs 2 5 % ,P =0 0 9) ,随访疗效优良者比例肝切除组优于非肝切除手术组 ( 86%vs 80 % ) ,但差别无统计学意义 (P =0 2 3 6)。结论 原发性肝胆管结石的手术治疗可采取多种方式 ,不同范围的肝叶切除治疗区域性肝内胆管结石 ,其效果优于单纯胆肠吻合和胆道外引流。各种措施的综合运用有助于减少术后残石。
Objective To evaluate the effect of surgical treatment for hepatolithiasis.Methods 504 patients with primary hepatolithiasis were surgically treated in our hospital in the past 10 years.The clinical findings,distributions of stones,patterns of operation,postoperative complications and residual stones were collected and retrospectively analyzed.Results Hepatectomy was the most commonly employed operation(55\^8%).The incidence of residual stone was 34\^6% for the whole group.Patients with hepatectomy had significantly less incidence of residual stone(21\^7% vs 53\^7%,P<0\^01)and had better therapeutic result(86% vs 80%,P=0\^236)than the patients with only operative biliary drainage or hepatobiliary anastomosis.The postoperative complication of hepatectomy was higher but not signiticantly different(5\^7% vs 2\^5%,P=0\^09).Conclusion Various surgical treatment methods can be employed in the treatment of primary hepatolithiasis.However,hepatectomy is now the most preferable in the treatment of regional hepatolithiasis.Combined use of various techniques can help to reduce the incidence of residual stone.
出处
《中国实用外科杂志》
CSCD
北大核心
2001年第8期492-493,共2页
Chinese Journal of Practical Surgery
